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Mendes Pereira C, Matos M, Carvalho D, Macedo P, Calheiros JM, Alves J, Paulino Ferreira L, Dias TL, Neves Madeira R, Jones F. Building Bridges between People with Stroke, Families, and Health Professionals: Development of a Blended Care Program for Self-Management. J Clin Med 2024; 13:300. [PMID: 38202307 PMCID: PMC10779663 DOI: 10.3390/jcm13010300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
Evidence-informed interventions for stroke self-management support can influence functional capability and social participation. People with stroke should be offered self-management support after hospital discharge. However, in Portugal, there are no known programs of this nature. This study aimed to develop a person-centered and tailored blended care program for post-stroke self-management, taking into account the existing evidence-informed interventions and the perspectives of Portuguese people with stroke, caregivers, and health professionals. An exploratory sequential mixed methods approach was used, including qualitative methods during stakeholder consultation (stage 1) and co-production (stage 2) and quantitative assessment during prototyping (stage 3). After ethical approval, recruitment occurred in three health units. Results from a literature search led to the adaptation of the Bridges Stroke Self-Management Program. In stage one, 47 participants were interviewed, with two themes emerging: (i) Personalized support and (ii) Building Bridges through small steps. In stage two, the ComVida program was developed, combining in-person and digital approaches, supported by a workbook and a mobile app. In stage three, 56 participants evaluated prototypes, demonstrating a strong level of quality. Understandability and actionability of the developed tools obtained high scores (91-100%). The app also showed good usability (A-grade) and high levels of recommendation (5 stars).
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Affiliation(s)
- Carla Mendes Pereira
- Department of Physiotherapy, School of Health, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (M.M.); (T.L.D.)
- Comprehensive Health Research Centre (CHRC), NOVA University of Lisbon, 1150-082 Lisbon, Portugal
| | - Mara Matos
- Department of Physiotherapy, School of Health, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (M.M.); (T.L.D.)
| | - Daniel Carvalho
- Local Health Unit Litoral Alentejano (ULSLA), 7540-230 Santiago do Cacém, Portugal;
| | - Patricia Macedo
- Research Center for Engineering a Sustainable Development (Sustain.RD), Setúbal School of Technology, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (P.M.); (R.N.M.)
- Center of Technology and Systems (UNINOVA-CTS), NOVA School of Science and Technology, 2829-516 Caparica, Portugal
| | - José M. Calheiros
- Institute for Research, Innovation and Development (FP-I3ID), University Fernando Pessoa, 4249-004 Porto, Portugal;
| | - Janice Alves
- Neurology Department, Setúbal Hospital Centre, 2910-446 Setúbal, Portugal;
| | - Luís Paulino Ferreira
- Department of Psychiatry and Mental Health, Setúbal Hospital Centre, 2910-446 Setúbal, Portugal;
| | - Teresa L. Dias
- Department of Physiotherapy, School of Health, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (M.M.); (T.L.D.)
| | - Rui Neves Madeira
- Research Center for Engineering a Sustainable Development (Sustain.RD), Setúbal School of Technology, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (P.M.); (R.N.M.)
- NOVA Laboratory of Computer Science and Informatics (NOVA LINCS), NOVA School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Fiona Jones
- Population Health Research Institute, St George’s, University of London, London SW17 ORE, UK;
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Baker RM, Ahmed M, Bertotti M, Cassidy J, Chipuriro R, Clewett E, Donaldson C, Elders A, Fenge LA, Fox J, Galway K, Gildea A, McGuinness A, McLean J, Manoukian S, Mason H, Morgan A, Mulholland J, O'Hare L, Paterson A, Porter S, Rendall J, Roy MJ, Seaman P, Simpson M, Steiner A, Kelly MP. Common health assets protocol: a mixed-methods, realist evaluation and economic appraisal of how community-led organisations (CLOs) impact on the health and well-being of people living in deprived areas. BMJ Open 2023; 13:e069979. [PMID: 36927592 PMCID: PMC10030928 DOI: 10.1136/bmjopen-2022-069979] [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] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION This research investigates how community-led organisations' (CLOs') use of assets-based approaches improves health and well-being, and how that might be different in different contexts. Assets-based approaches involve 'doing with' rather than 'doing to' and bring people in communities together to achieve positive change using their own knowledge, skills and experience. Some studies have shown that such approaches can have a positive effect on health and well-being. However, research is limited, and we know little about which approaches lead to which outcomes and how different contexts might affect success. METHODS AND ANALYSIS Using a realist approach, we will work with 15 CLOs based in disadvantaged communities in England, Scotland and Northern Ireland. A realist synthesis of review papers, and a policy analysis in different contexts, precedes qualitative interviews and workshops with stakeholders, to find out how CLOs' programmes work and identify existing data. We will explore participants' experiences through: a Q methodology study; participatory photography workshops; qualitative interviews and measure outcomes using a longitudinal survey, with 225 CLO participants, to assess impact for people who connect with the CLOs. An economic analysis will estimate costs and benefits to participants, for different contexts and mechanisms. A 'Lived Experience Panel' of people connected with our CLOs as participants or volunteers, will ensure the appropriateness of the research, interpretation and reporting of findings. ETHICS AND DISSEMINATION This project, research tools and consent processes have been approved by the Glasgow Caledonian University School of Health and Life Sciences Ethics Committee, and affirmed by Ethics Committees at Bournemouth University, Queen's University Belfast and the University of East London. Common Health Assets does not involve any National Health Service sites, staff or patients.Findings will be presented through social media, project website, blogs, policy briefings, journal articles, conferences and visually in short digital stories, and photographic exhibitions.
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Affiliation(s)
- Rachel Mairi Baker
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | | | - Marcello Bertotti
- Institute for Connected Communities, University of East London, London, UK
| | - John Cassidy
- Scottish Communities for Health and Wellbeing, Glasgow, UK
| | - Rejoice Chipuriro
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - Emma Clewett
- Institute for Connected Communities, University of East London, London, UK
| | - Cam Donaldson
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Andrew Elders
- NMAHP Research Unit, Glasgow Caledonian University School of Health and Life Sciences, Glasgow, UK
| | - Lee Ann Fenge
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - Julie Fox
- Annexe Communities Glasgow, Glasgow, UK
| | - Karen Galway
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Aideen Gildea
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | | | - Sarkis Manoukian
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Helen Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Antony Morgan
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Jill Mulholland
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Liam O'Hare
- Innovation Zones, School of Social Science, Education and Social Work, Queen's University Belfast, Belfast, UK
| | | | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - Jack Rendall
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Michael J Roy
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Peter Seaman
- Glasgow Centre for Population Health, Glasgow, UK
| | | | - Artur Steiner
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Michael P Kelly
- Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Doshi K, Henderson SL, Seah DJL, De Silva DA, Lee JJ, Huynh VA, Ozdemir S. Stroke survivors' preferences for post-stroke self-management programs: A discrete choice experiment. J Stroke Cerebrovasc Dis 2023; 32:106993. [PMID: 36669373 DOI: 10.1016/j.jstrokecerebrovasdis.2023.106993] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND PURPOSE Self-management programs enhance survival in stroke patients. However, they require patient-centered designs to be effective. The aim of this study was therefore to investigate the type of post-stroke self-management programs that appeal to stroke survivors, and to estimate their willingness to participate in such programs. METHODS A Discrete Choice Experiment was administered to patients who had either a transient ischemic attack (TIA) or stroke within the past 3 years and were cognitively intact (i.e., stroke survivors). Stroke survivors were presented with eight choice tasks and asked to choose between 'No Program' and two hypothetical post-stroke management programs that varied by six attributes: Topics covered by the program; schedule of the program; frequency and duration of the sessions; number of participants; out-of-pocket registration fee for the whole program; and rewards for completing the program. RESULTS The analysis involved 146 stroke survivors. Based on the mixed logit model, the predicted willingness to participate ranged from 53% to 76%. The most popular characteristics in a program were topics on health education and risk management, being scheduled during weekends as four sessions that are each 2 hours long and involve four participants, a registration fee of SGD50 (∼USD36), and SGD500 (∼USD359) reward for program completion. CONCLUSIONS Interest in post-stroke self-management programs was high, with at least half of the sample showing interest in participating in these programs. Program features such as focusing on health education and risk management, charging a low registration fee, and offering incentives helped to increase the demand.
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Affiliation(s)
- Kinjal Doshi
- Department of Psychology, Singapore General Hospital, Singapore.
| | | | | | - Deidre Anne De Silva
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital Campus, Singapore.
| | - Jia Jia Lee
- Signature Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore.
| | - Vinh Anh Huynh
- Signature Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore.
| | - Semra Ozdemir
- Signature Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore.
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