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Johansson JF, Shannon R, Mossabir R, Airlie J, Ozer S, Moreau LA, Farrin A, Mead G, English C, Fitzsimons CF, Clarke DJ, Forster A. Intervention to reduce sedentary behaviour and improve outcomes after stroke (Get Set Go): a study protocol for the process evaluation of a pilot cluster randomised controlled trial (RECREATE). BMJ Open 2023; 13:e075363. [PMID: 37699629 PMCID: PMC10503356 DOI: 10.1136/bmjopen-2023-075363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/16/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION Stroke survivors spend long periods of time engaging in sedentary behaviour (SB) even when their functional recovery is good. In the RECREATE programme, an intervention aimed at reducing SB ('Get Set Go') will be implemented and evaluated in a pragmatic external pilot cluster randomised controlled trial with embedded process and economic evaluations. We report the protocol for the process evaluation which will address the following objectives: (1) describe and clarify causal assumptions about the intervention, and its mechanisms of impact; (2) assess implementation fidelity; (3) explore views, perceptions and acceptability of the intervention to staff, stroke survivors and their carers; (4) establish the contextual factors that influence implementation, intervention mechanisms and outcomes. METHODS AND ANALYSIS This pilot trial will be conducted in 15 UK-based National Health Service stroke services. This process evaluation study, underpinned by the Medical Research Council guidance, will be undertaken in six of the randomised services (four intervention, two control). Data collection includes the following: observations of staff training sessions, non-participant observations in inpatient and community settings, semi-structured interviews with staff, patients and carers, and documentary analysis of key intervention components. Additional quantitative implementation data will be collected in all sites. Training observations and documentary analysis data will be summarised, with other observational and interview data analysed using thematic analysis. Relevant theories will be used to interpret the findings, including the theoretical domains framework, normalisation process theory and the theoretical framework of acceptability. Anticipated outputs include the following: recommendations for intervention refinements (both content and implementation); a revised implementation plan and a refined logic model. ETHICS AND DISSEMINATION The study was approved by Yorkshire & The Humber - Bradford Leeds Research Ethics Committee (REC reference: 19/YH/0403). Findings will be disseminated via peer review publications, and national and international conference presentations. TRIAL REGISTRATION NUMBER ISRCTN82280581.
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Affiliation(s)
- Jessica Faye Johansson
- Academic Unit of Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Academic Unit of Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Rosie Shannon
- Academic Unit of Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Rahena Mossabir
- Academic Unit of Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Jennifer Airlie
- Academic Unit of Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Seline Ozer
- Academic Unit of Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Lauren A Moreau
- Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (CTRU), University of Leeds, Leeds, UK
| | - Amanda Farrin
- Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (CTRU), University of Leeds, Leeds, UK
| | - Gillian Mead
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Coralie English
- School of Health Sciences, The University of Newcastle, Newcastle, New South Wales, Australia
- Heart and Stroke Research Program, The University of Newcastle Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Claire F Fitzsimons
- Physical Activity for Health and Research Centre, Institute for Sport Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | - David J Clarke
- Academic Unit of Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Academic Unit of Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Anne Forster
- Academic Unit of Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Academic Unit of Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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2
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Kilgore C. Advising older people on physical activity: challenges and strategies. Nurs Older People 2023; 35:24-29. [PMID: 36416270 DOI: 10.7748/nop.2022.e1410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 06/16/2023]
Abstract
Appropriate physical activity has more benefits than risks for older people. Increased physical activity enhances older people's mental and physical well-being and can contribute to reduced morbidity and early mortality. Nurses have an important role in advising older people on the level of physical activity that is right for them. Based on the national requirements for physical activity in older people, nurses can tailor their advice to each individual, address the person's concerns about potential risks and emphasise the likely benefits of them becoming more physically active. This article explains the role of nurses in promoting and encouraging physical activity in older people. It describes the historical background of this area of health promotion, considers the challenges nurses experience and discusses the strategies they can use when advising older people on physical activity.
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Affiliation(s)
- Cliff Kilgore
- Kings Park Hospital, Dorset Healthcare University NHS Foundation Trust, Bournemouth, England
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Rash I, Helgason M, Jansons D, Mitchell L, Sakakibara BM. The influence of a virtual reality entertainment program on depressive symptoms and sedentary behaviour in inpatient stroke survivors: a research protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 2022; 8:230. [PMID: 36273223 PMCID: PMC9587642 DOI: 10.1186/s40814-022-01189-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background
Sedentary behaviour among stroke inpatients may be due to high rates of depressive symptoms after stroke. Thus, efforts to address depressive symptoms among stroke inpatients are warranted to in turn lessen sedentary behaviour. Despite evidence that virtual reality (VR) is emerging as a method to help with depression, the use of VR to improve depression among inpatient stroke survivors has yet to be studied. In this paper, we report on the protocol investigating the feasibility of a VR entertainment system at improving depressive symptoms among stroke survivors receiving inpatient rehabilitation. Methods In this single-blind randomized controlled trial, 30 inpatient stroke survivors from the rehabilitation unit at Kelowna General Hospital will be randomized to either (1) intervention: 3 times per week of VR entertainment for duration of inpatient rehabilitation or (2) control: usual care. Individuals will be included if they have a confirmed diagnosis of stroke, are 19 years of age or older, able to provide informed consent, have physician clearance to participate in the study (medically stable or fit), or are able to understand English. Outcome measures to address depressive symptoms (primary outcome), sedentary behaviour, motivation, anxiety, stress, and happiness (secondary outcome) will be administered at two timepoints: (1) baseline (T1) and (2) post-intervention (T2). Study analyses will consider study feasibility indicators and clinical (statistical) outcomes. Means and standard deviations (for continuous variables) and frequencies and proportions (for categorical variables) will be used to summarize the variables. Feasibility indicators will be dichotomized into either ‘success’ if they meet the a priori criteria, or ‘revise’ if they do not meet the criteria. Intervention effects post-intervention (T2) for the primary and secondary clinical outcomes will be estimated using linear regression including baseline (T1) controlling for age and sex. Discussion The results of this trial will add to our understanding of depression and sedentary behaviour among individuals receiving inpatient stroke rehabilitation as well as the feasibility of a VR entertainment program to improve depressive symptoms, which will in turn may lessen sedentary behaviour in inpatient stroke survivors. Trial registration ClinicalTrials.gov Identifier: NCT04011202
. First posted July 8, 2019 (study postponed from March 2020 to July 2021 due to COVID-19). Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01189-8.
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Affiliation(s)
- Isabelle Rash
- Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, Canada.,Centre for Chronic Disease Prevention and Management, Southern Medical Program, The University of British Columbia Okanagan, 1088 Discovery Avenue, Kelowna, BC, V1V 1V7, Canada
| | | | | | | | - Brodie M Sakakibara
- Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, Canada. .,Centre for Chronic Disease Prevention and Management, Southern Medical Program, The University of British Columbia Okanagan, 1088 Discovery Avenue, Kelowna, BC, V1V 1V7, Canada. .,Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, Canada.
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Stewart CE, Branyan TE, Sampath D, Sohrabji F. Sex Differences in the Long-Term Consequences of Stroke. Curr Top Behav Neurosci 2022; 62:287-308. [PMID: 35332459 DOI: 10.1007/7854_2022_311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Stroke is the fifth leading cause of death and as healthcare intervention improves, the number of stroke survivors has also increased. Furthermore, there exists a subgroup of younger adults, who suffer stroke and survive. Given the overall improved survival rate, bettering our understanding of long-term stroke outcomes is critical. In this review we will explore the causes and challenges of known long-term consequences of stroke and if present, their corresponding sex differences in both old and young survivors. We have separated these long-term post-stroke consequences into three categories: mobility and muscle weakness, memory and cognitive deficits, and mental health and mood. Lastly, we discuss the potential of common preclinical stroke models to contribute to our understanding of long-term outcomes following stroke.
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Affiliation(s)
- Courtney E Stewart
- Women's Health in Neuroscience Program, Neuroscience and Experimental Therapeutics, Texas A&M Health Science Center College of Medicine, Bryan, TX, USA
| | - Taylor E Branyan
- Women's Health in Neuroscience Program, Neuroscience and Experimental Therapeutics, Texas A&M Health Science Center College of Medicine, Bryan, TX, USA.,Texas A&M Institute for Neuroscience, College Station, TX, USA
| | - Dayalan Sampath
- Women's Health in Neuroscience Program, Neuroscience and Experimental Therapeutics, Texas A&M Health Science Center College of Medicine, Bryan, TX, USA
| | - Farida Sohrabji
- Women's Health in Neuroscience Program, Neuroscience and Experimental Therapeutics, Texas A&M Health Science Center College of Medicine, Bryan, TX, USA. .,Texas A&M Institute for Neuroscience, College Station, TX, USA.
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Markus HS. Palliative care, increasing activity following stroke, and whether to use bridging therapy before thrombectomy. Int J Stroke 2021; 16:619-620. [PMID: 34382481 DOI: 10.1177/17474930211035600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hannan M, Kringle E, Hwang CL, Laddu D. Behavioral Medicine for Sedentary Behavior, Daily Physical Activity, and Exercise to Prevent Cardiovascular Disease: A Review. Curr Atheroscler Rep 2021; 23:48. [PMID: 34226989 PMCID: PMC8257263 DOI: 10.1007/s11883-021-00948-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Behavioral medicine is a multidisciplinary field that has a key role in reducing risk factors for cardiovascular disease (CVD). The purpose of this review is to describe the role of behavioral medicine for CVD prevention, using physical activity behaviors (e.g., sedentary behavior, daily physical activity, or exercise) as an exemplar. Application of behavioral medicine to improve dietary behaviors is also briefly discussed. RECENT FINDINGS Behavioral medicine interventions that address physical activity behaviors are associated with improved cardiovascular risk factors. Interventions framed in behavior change theory that integrate behavior change techniques to reduce sedentary behavior and promote daily physical activity and exercise have similarly been applied to improve certain dietary behaviors and show promise for reducing CVD risk factors. Behavioral medicine has an important role in improving various physical activity behaviors for all populations, which is essential for preventing or managing CVD. Further investigation into behavioral medicine interventions that address personal, environmental, and social factors that influence participation in physical activity behaviors, as well as the adoption of a more optimal dietary pattern, is warranted.
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Affiliation(s)
- Mary Hannan
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL USA
| | - Emily Kringle
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL USA
| | - Cheuh-Lung Hwang
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor Street (MC 898), Chicago, IL USA
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor Street (MC 898), Chicago, IL USA
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Hendrickx W, Riveros C, Askim T, Bussmann JBJ, Callisaya ML, Chastin SFM, Dean C, Ezeugwu V, Jones TM, Kuys SS, Mahendran N, Manns PJ, Mead G, Moore SA, Paul L, Pisters MF, Saunders DH, Simpson DB, Tieges Z, Verschuren O, English C. An Exploration of Sedentary Behavior Patterns in Community-Dwelling People With Stroke: A Cluster-Based Analysis. J Neurol Phys Ther 2021; 45:221-227. [PMID: 33867457 DOI: 10.1097/npt.0000000000000357] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Long periods of daily sedentary time, particularly accumulated in long uninterrupted bouts, are a risk factor for cardiovascular disease. People with stroke are at high risk of recurrent events and prolonged sedentary time may increase this risk. We aimed to explore how people with stroke distribute their periods of sedentary behavior, which factors influence this distribution, and whether sedentary behavior clusters can be distinguished? METHODS This was a secondary analysis of original accelerometry data from adults with stroke living in the community. We conducted data-driven clustering analyses to identify unique accumulation patterns of sedentary time across participants, followed by multinomial logistical regression to determine the association between the clusters, and the total amount of sedentary time, age, gender, body mass index (BMI), walking speed, and wake time. RESULTS Participants in the highest quartile of total sedentary time accumulated a significantly higher proportion of their sedentary time in prolonged bouts (P < 0.001). Six unique accumulation patterns were identified, all of which were characterized by high sedentary time. Total sedentary time, age, gender, BMI, and walking speed were significantly associated with the probability of a person being in a specific accumulation pattern cluster, P < 0.001 - P = 0.002. DISCUSSION AND CONCLUSIONS Although unique accumulation patterns were identified, there is not just one accumulation pattern for high sedentary time. This suggests that interventions to reduce sedentary time must be individually tailored.Video Abstract available for more insight from the authors (see the Video Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A343).
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Affiliation(s)
- Wendy Hendrickx
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (W.H., M.F.P.); School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia (W.H., D.B.S., C.E.); Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands (W.H., M.F.P.); Bioinformatics, Hunter Medical Research Institute, and School of Medicine and Public Health, University of Newcastle, Newcastle, Australia (C.R.); Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway (T.A.); Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands (J.B.J.B.); Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (M.L.C.); School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom (S.F.M.C., L.P., Z.T.); Department of Movement and Sports Sciences, Faculty of Medicine and Health Science, Ghent University, Ghent, Belgium (S.F.M.C.); Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia (C.D., T.M.J.); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada (V.E., P.J.M.); National Head, School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia (S.S.K.); Discipline of Physiotherapy, Faculty of Health, University of Canberra, Canberra, Australia (N.M.); Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (G.M.); Stroke Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom (S.A.M.); Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands (M.F.P.); Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, United Kingdom (D.H.S.); Department of Geriatric Medicine, University of Edinburgh, United Kingdom (Z.T.); UMC Utrecht Brain Center, Center of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (O.V.); and Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience and Hunter Medical Research Institute, Newcastle, Australia (C.E.)
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Kringle EA, Terhorst L, Gibbs BB, Campbell G, McCue M, Skidmore ER. Activating Behavior to Reduce Sedentary Behavior After Stroke: A Nonrandomized Pilot Feasibility Study. Am J Occup Ther 2020; 74:7406205030p1-7406205030p10. [PMID: 33275563 PMCID: PMC7717647 DOI: 10.5014/ajot.2020.040345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Importance: Reducing poststroke sedentary behavior is important for reducing recurrent stroke risk, yet interventions to achieve this are scant. Objective: To assess the feasibility of, and estimate change in sedentary behavior over time associated with, a behavioral intervention. Design: Single-arm delayed baseline with postintervention and 8-wk follow-up assessment. Setting: Community based. Participants: Ambulatory, community-dwelling people with chronic stroke and reported ≥6 hr daily sitting time (N = 21). Intervention: Activating Behavior for Lasting Engagement (ABLE) was delivered by an occupational therapist 3×/wk for 4 wk. ABLE involves activity monitoring, activity scheduling, self-assessment, and collaborative problem solving. Outcomes and Measures: Feasibility (participant safety, adherence, satisfaction, and reliable intervention delivery) was assessed against preestablished benchmarks. Changes over time in sedentary behavior (assessed with an ActivPAL micro3 device) and participation (Stroke Impact Scale–Participation subscale) were described. Results: ABLE was safe (0 serious adverse events), adhered to (11.95 sessions/participant), and reliably delivered (90.00%–97.50% adherence). Participant satisfaction was unmet (Client Satisfaction Questionnaire–8, M = 28.75, SD = 3.84). ABLE was associated with a mean group reduction in prolonged sitting of 54.95 min (SD = 81.10) at postintervention and 14.08 (SD = 58.95) at follow-up. ABLE was associated with a negligible mean group increase over time in participation at postintervention (M = 1.48%, SD = 8.52) and follow-up (M = 1.33%, SD = 15.38). Conclusions and Relevance: The ABLE intervention is feasible and may be associated with within-group reduction in sedentary behavior over time. Further refinement is indicated. What This Article Adds: The ABLE intervention uses engagement in meaningful daily activities to reduce sedentary behavior after stroke. These findings suggest that ABLE can be delivered safely and consistently. Further research is required to enhance participant satisfaction and determine the effects of ABLE on stroke survivors’ sedentary behavior.
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Affiliation(s)
- Emily A Kringle
- Emily A. Kringle, PhD, OTR/L, is Postdoctoral Research Fellow, Division of Academic Internal Medicine and Geriatrics, College of Medicine, University of Illinois at Chicago. At the time of the study, she was Graduate Student Researcher, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA;
| | - Lauren Terhorst
- Lauren Terhorst, PhD, is Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Bethany Barone Gibbs
- Bethany Barone Gibbs, PhD, is Associate Professor, Department of Health and Human Development, School of Education, University of Pittsburgh, Pittsburgh, PA
| | - Grace Campbell
- Grace Campbell, PhD, RN, is Assistant Professor, Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA
| | - Michael McCue
- Michael McCue, PhD, is Professor, Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Elizabeth R Skidmore
- Elizabeth R. Skidmore, PhD, OTR/L, is Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
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9
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Hall J, Morton S, Hall J, Clarke DJ, Fitzsimons CF, English C, Forster A, Mead GE, Lawton R. A co-production approach guided by the behaviour change wheel to develop an intervention for reducing sedentary behaviour after stroke. Pilot Feasibility Stud 2020; 6:115. [PMID: 32821421 PMCID: PMC7429798 DOI: 10.1186/s40814-020-00667-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 08/07/2020] [Indexed: 11/10/2022] Open
Abstract
Background Stroke survivors are highly sedentary; thus, breaking up long uninterrupted bouts of sedentary behaviour could have substantial health benefit. However, there are no intervention strategies specifically aimed at reducing sedentary behaviour tailored for stroke survivors. The purpose of this study was to use co-production approaches to develop an intervention to reduce sedentary behaviour after stroke. Methods A series of five co-production workshops with stroke survivors, their caregivers, stroke service staff, exercise professionals, and researchers were conducted in parallel in two-stroke services (England and Scotland). Workshop format was informed by the behaviour change wheel (BCW) framework for developing interventions and incorporated systematic review and empirical evidence. Taking an iterative approach, data from activities and audio recordings were analysed following each workshop and findings used to inform subsequent workshops, to inform both the activities of the next workshop and ongoing intervention development. Findings Co-production workshop participants (n = 43) included 17 staff, 14 stroke survivors, six caregivers and six researchers. The target behaviour for stroke survivors is to increase standing and moving, and the target behaviour for caregivers and staff is to support and encourage stroke survivors to increase standing and moving. The developed intervention is primarily based on co-produced solutions to barriers to achieving the target behaviour. The developed intervention includes 34 behaviour change techniques. The intervention is to be delivered through stroke services, commencing in the inpatient setting and following through discharge into the community. Participants reported that taking part in intervention development was a positive experience. Conclusions To our knowledge, this is the first study that has combined the use of co-production and the BCW to develop an intervention for use in stroke care. In-depth reporting of how a co-production approach was combined with the BCW framework, including the design of bespoke materials for workshop activities, should prove useful to other researchers and practitioners involved in intervention development in stroke.
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Affiliation(s)
- Jennifer Hall
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Bradford, BD9 6RJ UK.,Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ UK
| | - Sarah Morton
- Centre for Clinical Brain Sciences, University of Edinburgh, EH16 4A, Edinburgh, UK
| | - Jessica Hall
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Bradford, BD9 6RJ UK.,Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ UK
| | - David J Clarke
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Bradford, BD9 6RJ UK
| | - Claire F Fitzsimons
- Physical Activity for Health Research Centre, St Leonards Land, Holyrood Road, Edinburgh, EH8 8AQ UK
| | - Coralie English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
| | - Anne Forster
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Bradford, BD9 6RJ UK
| | - Gillian E Mead
- Centre for Clinical Brain Sciences, University of Edinburgh, EH16 4A, Edinburgh, UK
| | - Rebecca Lawton
- School of Psychology, University of Leeds, Leeds, LS2 9JT UK
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Kringle EA, Campbell G, McCue M, Barone Gibbs B, Terhorst L, Skidmore ER. Development and feasibility of a sedentary behavior intervention for stroke: a case series. Top Stroke Rehabil 2019; 26:456-463. [DOI: 10.1080/10749357.2019.1623437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Emily A. Kringle
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Grace Campbell
- Department of Acute and Tertiary Care Nursing, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael McCue
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bethany Barone Gibbs
- Department of Health and Physical Activity, School of Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Elizabeth R. Skidmore
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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