Twenty years of the fitness and mobility exercise (FAME) program for people post-stroke: a multi-data source evaluation of implementation using the RE-AIM framework.

Abstract

The Fitness and Mobility Exercise (FAME) program is an evidence‑based, community program designed to support stroke recovery. The extent of real‑world implementation of FAME is unknown. To evaluate the dissemination and implementation of FAME. This mixed‑methods, multi-data source study used the RE-AIM Framework to synthesize bibliometric analysis, FAME manual downloaders data, and an online survey of manual downloaders. Quantitative data were summarized descriptively. Qualitative responses underwent inductive content analysis. Findings were converged and triangulated using the RE‑AIM Framework. Thirty‑five publications were identified, demonstrating evidence through randomized trials (49%) and international research uptake (43% outside Canada). Between 2015-2024, 4279 individuals downloaded the manual; 188 completed the online survey. The <i>Reach</i> of FAME has primarily been stroke survivors, but also reached non-stroke neurological and non-neurological populations. <i>Effectiveness</i> has been tested beyond physical outcomes, including cognition. Manual downloads data indicated that <i>Adoption</i> has been primarily by physiotherapists (49%) within healthcare settings (42%). Survey data indicated <i>Implementation</i> facilitators as primarily the ease of finding equipment (51%) and meeting user priorities and goals (48%). <i>Maintenance</i> barriers were primarily staffing‑related (48%). FAME has achieved global implementation beyond the stroke population. The findings highlight the need to further support community-based adoption.