Participants’ Perspective of Engaging in a Gym-Based Health Service Delivered Secondary Stroke Prevention Program after TIA or Mild Stroke

Abstract

People who have had a transient ischemic attack (TIA) or mild stroke have a high risk of recurrent stroke. Secondary prevention programs providing support for meeting physical activity recommendations may reduce this risk. Most evidence for the feasibility and effectiveness of secondary stroke prevention arises from programs developed and tested in research institute settings with limited evidence for the acceptability of programs in ‘real world’ community settings. This qualitative descriptive study explored perceptions of participation in a secondary stroke prevention program (delivered by a community-based multidisciplinary health service team within a community gym) by adults with TIA or mild stroke. Data gathered via phone-based semi-structured interviews midway through the program, and at the end of the program, were analyzed using constructivist grounded theory methods. A total of 51 interviews from 30 participants produced two concepts. The first concept, “What it offered me”, describes critical elements that shape participants’ experience of the program. The second concept, “What I got out of it” describes perceived benefits of program participation. Participants perceived that experiences with peers in a health professional-led group program, held within a community-based gym, supported their goal of changing behaviour. Including these elements during the development of health service strategies to reduce recurrent stroke risk may strengthen program acceptability and subsequent effectiveness.

Evaluating Feasibility of a Secondary Stroke Prevention Program

“…The education, support and coaching were guided by evidence and principles of behaviour change [18,28]. The program employed skills and experience from a multidisciplinary team experienced in adapting programs for people with stroke [23,24]. Participants gave input to the program in terms of design, content and scheduling.…”

“…Moreover, the use of telehealth has been feasible and may improve access to stroke care [22]. Factors that support people with stroke to be physically active and address lifestyle risk factors include guidance by health professionals who understand stroke, peer support and approaches that incorporate goaldirected and behavioural change [23,24]. These factors are consistent with the wishes of stroke survivors, who want more information on how to prevent stroke, including guidance on lifestyle and exercise [25,26], but these resources may not be provided routinely when people leave the hospital.…”