Development of a chronic disease management program for stroke survivors using intervention mapping: The Stroke Coach

Publication date: Available online 20 February 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Brodie M. Sakakibara, Scott A. Lear, Susan I. Barr, Oscar Benavente, Charlie H. Goldsmith, Noah D. Silverberg, Jennifer Yao, Janice J. Eng
ObjectiveTo describe the systematic development of the Stroke Coach, a theory- and evidence-based intervention to improve control of lifestyle behaviour risk factors in stroke patients.DesignIntervention development.SettingCommunity.ParticipantsIndividuals who have had a stroke.InterventionWe used Intervention Mapping to guide the development of the Stroke Coach. Intervention Mapping is a systematic process used for intervention development and comprised of steps that progress from the integration of theory and evidence to the organization of realistic strategies to facilitate the development of a practical intervention supported by empirical evidence. Social Cognitive Theory was the underlying premise for behaviour change, while Control Theory methods were directed towards sustaining the changes to ensure long-term health benefits. Practical evidence-based strategies were linked to behavioural determinants to improve stroke risk factor control.Main outcome measuresNot applicable.ResultsThe Stroke Coach is a patient-centred, community-based, telehealth intervention to promote healthy lifestyles after stroke. Over six months, participants receive seven 30 to 60 minute telephone sessions with a lifestyle coach who provides education, facilitates motivation for lifestyle modification, and empowers participants to self-management their stroke risk factors. Participants also receive a self-management manual and a self-monitoring kit.ConclusionThrough the use of Intervention Mapping we developed a theoretically sound and evidence-grounded intervention to improve risk factor control in stroke patients. If empirical evaluation of the Stroke Coach produces positive results, the next step will be to develop an implementation intervention to ensure successful uptake and delivery of the program in community and outpatient settings.



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