Title: Leisure and social activities after stroke: development and feasabillity testing of a peer led intervention
Funder: Division for Social Care and Health Research (Wales)

Abstract: After a stroke, people find it difficult to resume meaningful participation in social and leisure activities (SLAs). This is problematic, as research shows that those people who do not engage in SLAs are more likely to become depressed [1] and have reduced quality of life [2]. Importantly, participation in leisure activities is a useful coping strategy for people up to one year after stroke [3], and is consistently identified as a service development priority affected by stroke [4]. As statutory organisations try to control spending, new approaches to address persistent service challenges, including those associated with SLAs after stroke, are required. drawing on Bangor University’s expertise and evidence from the sports sciences, the proposed research involves working collaboratively with statutory organisations, charities and others to design a new ‘coaching; intervention that is delivered by appropriately trained and supervised peer (people who have previously had suffered a stroke). The intervention will be offered to people attending the six month follow-up assessment of stroke-related needs. Peer-led interventions for stroke mostly relate to the prevention of future strokes through health education. Involving peers with re-negotiating leisure activities is different and innovative. The intervention includes face-to-face sessions between people affected by stroke, one of who will have received training in coaching and transformational leadership. The focus on peer support will enable new ways of supporting people to rebuild SLAs that are grounded in ‘real world experiences’. Working actively with NISCHR’s Cynnwls Pobl / Involving People team, and with representatives from advocacy organisations such as the Stoke Association, we will ensure good practice in public involvement in research. Peer coaches will be provided with training and on-going supervision from an expert sports scientist coach. Our research will include: • In-depth interviews with up to 20 people at between 6 months and 1 year after stroke to explore their beliefs and experiences of social and leisure activities. • A feasibility study of peer coaching with up to 20 people affected by stroke in North Wales. We will: o Offer the peer coaching consecutively to people attending for 6 month review of their stroke-related problems and needs o Compare the personal characteristics (e.g. age, gender, health problems and social circumstances, recovery/behavioural beliefs) of those people who decline or accept the offer, and explore the reasons why people decline in a brief interview. o Use a range of measurement tools to investigate the effects of peer coaching on outcomes over time (e.g. mood, confidence, behavioural beliefs, time spent in leisure activities, activities of daily living, social participation) o Use in-depth interviews with ‘peer coaches’ and their supervisor, and those people receiving the ‘peer coaching’ to understand ‘what works’. Facilitation of a network of organisations and services from local authorities (e.g. leisure and sports development), stroke advocacy organisations (e.g. Stroke Association), social care and health care services, and relevant initiatives (e.g. National Exercise Referral Scheme). Using a mix of focus group interviews and development activities, this network will be construct an integrated approach to addressing leisure needs after stroke.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;7.3 MANAGEMENT AND DECISION MAKING
Health categories: STROKE