Adapting a telehealth physical activity and diet intervention to a co-designed website for self-management after stroke: Tutorial. (Preprint)

Abstract

UNSTRUCTURED People who experience a stroke are at a higher risk of recurrent stroke when compared with people who have not had a stroke. Addressing modifiable risk factors like physical inactivity and poor diet has been shown to improve blood pressure, a leading contributor to stroke. However, survivors of stroke often experience challenges in accessing risk reduction services including long wait lists, difficulty with transportation, fatigue, impaired function, and diminished exercise capacity. Providing health interventions via a website can extend the reach when compared with programs delivered through traditional means. Given global challenges of accessing secondary prevention programs it is important to consider alternative ways that this information can be made available to survivors of stroke worldwide. Using the integrated knowledge translation approach, we applied principles from the “design thinking” methodology to adapt two co-designed telehealth programs called i-REBOUND – ‘Let’s get moving’ (Physical Activity intervention) and i-REBOUND – ‘Eat for health’ (Diet Intervention) to create the i-REBOUND - after stroke website. The aim of this paper is to describe the systematic process undertaken to adapt resources from the telehealth delivered i-REBOUND – ‘Let’s get moving’ and the i-REBOUND – ‘Eat for health’ programs to a website prototype with a focus on navigation requirements and accessibility for survivors of stroke. We engaged a variety of key stakeholders with diverse skills and expertise in areas of stroke recovery, research, and digital health. We established a governance structure, formed a consumer advisory group, appointed a diverse project team and agreed on scope of the project. Our process of adaptation had three phases: (1) understand, (2) explore, (3) materialise. In this paper we provide a road map for the steps taken to adapt resources from two telehealth delivered programs to a website format which meets specific navigation and accessibility needs of survivors of stroke.