A behaviour change program to increase outings delivered during therapy to stroke survivors by community rehabilitation teams : The Out-and-About trial

Journal article


McCluskey, Annie, Ada, Louise, Kelly, Patrick J., Middleton, Sandy, Goodall, Stephen, Grimshaw, Jeremy M., Logan, Pip, Longworth, Mark and Karageorge, Aspasia. (2016) A behaviour change program to increase outings delivered during therapy to stroke survivors by community rehabilitation teams : The Out-and-About trial. International Journal of Stroke. 11(4), pp. 425-437. https://doi.org/10.1177/1747493016632246
AuthorsMcCluskey, Annie, Ada, Louise, Kelly, Patrick J., Middleton, Sandy, Goodall, Stephen, Grimshaw, Jeremy M., Logan, Pip, Longworth, Mark and Karageorge, Aspasia
Abstract

Background: Australian guidelines recommend that outdoor mobility be addressed to increase participation after stroke.

Aim: To investigate the efficacy of the Out-and-About program at increasing outings delivered during therapy by community teams, and outings taken by stroke survivors in real life.

Method: Cluster-randomised trial involving 22 community teams providing stroke rehabilitation. Experimental teams received the Out-and-About program (a behaviour change program comprising a training workshop with barrier identification and booster session, printed educational materials, audit and feedback). Control teams received printed clinical guidelines only. The primary outcome was the percentage of stroke survivors receiving four or more outings during therapy. Secondary outcomes included the number of outings received by stroke survivors during therapy and undertaken in real life.

Results: At 12 months after implementation of the behaviour change program, 9% audited experimental group stroke survivors received four or more outings during therapy compared with 5% in the control group (adjusted risk difference 4%, 95% CI -9 to 17, p=0.54). They received 1.1 (SD 0.9) outings during therapy compared with 0.6 (SD 1.0) in the control group (adjusted mean difference 0.5, 95% CI -0.4 to 1.4; p=0.26). After 6 months of rehabilitation, observed experimental group stroke survivors took 9.0 (SD 3.0) outings per week in real life compared with 7.4 (SD 4.0) in the control group (adjusted mean difference 0.5, 95% CI -1.8 to 2.8; p = 0.63).

Conclusion: The Out-and-About program did not change team or stroke survivor behaviour.

Keywordsphysical therapy; occupational therapy; physiotherapy; knowledge translation; walking
Year2016
JournalInternational Journal of Stroke
Journal citation11 (4), pp. 425-437
PublisherWorld Stroke Organization
ISSN1747-4930
Digital Object Identifier (DOI)https://doi.org/10.1177/1747493016632246
Scopus EID2-s2.0-84964619872
Open accessPublished as green open access
Research or scholarlyResearch
Page range425-437
FunderNational Health and Medical Research Council
Research GroupNursing Research Institute
Author's accepted manuscript
File Access Level
Open
Publisher's version
License
All rights reserved
File Access Level
Controlled
Grant IDNHMRC/632721
Place of publicationUnited Kingdom
EditorsG. A. Donnan
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