Evaluation of the Adherence Counselling Toolkit (ACT now): supporting health professionals to support survivors of stroke to self-manage.

Abstract

This Type 1 Hybrid effectiveness-implementation pilot study aimed to determine the effectiveness of the <b>ACTnow Toolkit</b> for promoting adherence to exercise in survivors of stroke and improving self-efficacy in both survivors and healthcare professionals. A secondary aim was to identify factors influencing toolkit implementation. The <b>ACTnow Toolkit</b> was implemented with 30 survivors of stroke by healthcare professionals in a tertiary hospital. Adherence was measured using diaries and focus groups with healthcare professionals. Confidence levels were measured using the Self-Efficacy for Exercise (SEE) Scale for survivors of stroke and Evidence-Based Practice Confidence Scale (EPIC) for healthcare professionals, at baseline and 1-month. Feasibility was evaluated through surveys. The toolkit provides extensive assessment tools and resources to support the collaborative development of tailored physical activity programs. Survivors of stroke adhered to 74% of their exercise programs and significantly improved their SEE scores. Healthcare professionals' confidence to deliver tailored exercise programs improved. Most healthcare professionals felt able to deliver the toolkit as per instructions and found it helpful for improving physical activity recommendations. Healthcare professionals reported that the toolkit was feasible for program development, acceptable, facilitated conversations, and goal setting. Survivors of stroke reported enhanced motivation and accountability to their prescribed program. This pilot study has demonstrated the <b>ACTnow Toolkit's</b> effectiveness in a rehabilitation setting for promoting exercise adherence and self-efficacy in survivors of stroke, and confidence with shared program development for health professionals.