A process evaluation of a randomized controlled trial of an enhanced rehabilitation transition program for stroke survivors.
rct · Level II
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- Record sourced from PubMed, PMID 41205849.
- Also identified by DOI 10.1016/j.apmr.2025.10.016.
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Abstract
To fully describe the key elements for implementation of the Community Participation Transition after Stroke (COMPASS) intervention for stroke survivors returning home from inpatient rehabilitation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Process evaluation of an RCT of the COMPASS intervention SETTING: Inpatient rehabilitation (IR) and participants' homes PARTICIPANTS: 185 stroke survivors who were 50 years of age or older, experienced an acute ischemic stroke or intracerebral hemorrhage, were independent in activities of daily living before their stroke, and planned to discharge home from IR. Participants were randomized to receive the COMPASS intervention (home modifications and strategy training, n=85) or attentional control (AC; stroke education, n=100). Both groups received 4 visits in the home. Components of the RE-AIM framework RESULTS: 51.8% of eligible stroke survivors participated in this study. More COMPASS participants completed the intervention than AC participants (94.1% vs. 75.0%; reach). COMPASS participants experienced greater improvements in self-rated performance and satisfaction and barrier severity than AC participants at 12-month follow-up (effectiveness). Approximately 89% of intervention components were implemented in an average of 5.5 postdischarge home visits (average 289 minutes, SD 172). An average of 9.9 home modifications/recommendations were made per participant, and the median cost of adaptive equipment and contractor labor and materials was $544 ($275-$754; implementation). Adherence to home modifications at 12 months was 82.4% (SD 0.24; maintenance). COMPASS had good reach and was effective in improving stroke survivors' self-rated performance and satisfaction and in reducing environmental barriers to daily activities. COMPASS was implemented with fidelity and low cost in a sample of stroke survivors.