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How Community-Based Teams Used the Stroke Recovery in Motion

Background: 

As more people survive stroke, there is a growing need for services and programs that support the long-term needs of people living with the effects of stroke. Exercise has many benefits, yet most people with stroke do not have access to specialized exercise programs that meet their needs in their communities. To catalyze the implementation of these programs, our team developed the Stroke Recovery in Motion “Planner.” The Planner guides teams through the process of planning for the implementation of community-based exercise programs for people with stroke, in alignment with implementation science frameworks and evidence. The purpose of this study was to conduct a field-test with end-users to: 1) describe how teams used the Planner in real-world conditions; 2) describe the effects of Planner use on participants’ implementation planning knowledge, attitudes, and activities; and 3) identify factors influencing use of the Planner.

Methods: 

This field-test study used a longitudinal qualitative design. We recruited teams across Canada who intended to implement a community-based exercise program for people with stroke in the next 6-12 months and were willing to use the Planner to guide their work. We completed semi-structured interviews at time of enrollment and at end-of-study, as well as monitoring calls every 1-2 months, to learn about implementation planning work completed and Planner use. Interviews were analyzed using conventional content analysis. Completed Planner steps were plotted onto a timeline for comparison across teams.

Results: 

We enrolled 12 participants (program managers and coordinators, rehabilitation professionals, fitness professionals) from five planning teams. Teams were enrolled in the study between 4-14 months and, in total, we conducted 25 interviews. We observed that teams worked through the implementation planning process in diverse and non-linear ways, adapted to their context. All teams provided examples of how using the Planner changed their implementation planning knowledge (e.g., knowing the steps), attitudes (e.g., increased value on community engagement), and activities (e.g., hosting a stakeholder meeting for the first time). We identified team, organizational, and broader contextual factors that hindered and facilitated uptake of the Planner. Participants shared valuable “tips from the field” to help future teams optimize use of the Planner.

Conclusions: 

The Stroke Recovery in Motion Planner is an adaptable resource that may be used in diverse settings to plan community-based exercise programs for people with stroke. These findings may be informative to others who are developing resources to build the capacity of those working in community-based settings to implement new programs and practices. Future work is needed to monitor use and understand the effect of using the Planner on exercise program implementation and sustainability.

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