iADAPT to Support Strategy Training After Stroke

Study Overview
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Brief Summary
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Adherence to rehabilitation interventions is associated with functional outcomes (e.g. independence in daily activities, return of motor function) after stroke. Low adherence to rehabilitation home programs is common after stroke. Interventions delivered via mobile health applications demonstrated positive effects on adherence to health behaviors (e.g. medication routines, smoking cessation). The investigators developed the iADAPT mobile application to support adherence to Strategy Training. Strategy Training is an iterative rehabilitation intervention the promotes goal setting, planning, and self-monitoring after stroke. This study examines the effects of the iADAPT mobile health application relative to a workbook on adherence to Strategy Training after stroke.

Official Title
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iADAPT to Support Strategy Training After Stroke

Conditions
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Stroke, Adherence, Patient, Strategy Training

Intervention / Treatment
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* Behavioral: Strategy Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: -Diagnosis of Stroke Exclusion Criteria: prior exposure to Strategy Training vision impairment that impairs ability to read device screen or worksheet poor self-awareness (score of ≥2 on Self Awareness of Deficits Inventory item #1 or #2 current major depressive, bipolar, or psychotic disorder (Patient Health Questionnaire-9, PRIME-MD) current alcohol or drug abuse (Mini International Neuropsychiatric Interview) severe aphasia (score ≤1 on Boston Diagnostic Aphasia Examination) current diagnosis of dementia, neurodegenerative disease, or cancer anticipated discharge to a skilled nursing facility

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 105 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Strategy Training: iADAPT Application<br>Participants will use the iADAPT mobile health application to supplement to in-person and remote intervention sessions. | Behavioral: Strategy Training<br>* Strategy training is a form of meta-cognitive instruction that trains individuals with stroke-related cognitive impairments to identify and prioritize problematic daily activities, identify the barriers impeding performance, generate and evaluate their own strategies to address barriers, and apply these skills through iterative practice.<br>|
| Active Comparator: Strategy Training: Workbook<br>Participants will use a printed workbook to supplement to in-person and remote (by telephone) intervention sessions. | Behavioral: Strategy Training<br>* Strategy training is a form of meta-cognitive instruction that trains individuals with stroke-related cognitive impairments to identify and prioritize problematic daily activities, identify the barriers impeding performance, generate and evaluate their own strategies to address barriers, and apply these skills through iterative practice.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adherence: Observed client behavior | Number of completed activity trials in the iADAPT application or Workbook | Baseline to 3 months | 
| Adherence: Client-reported progress on goals. | Client rating of independence with self-selected goals (measured using Canadian Occupational Performance Measure) | Baseline and 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adherence: Client perspectives on treatment environment | Client rating on patient-provider connection and treatment expectancy measured by Healing Encounters and Attitudes Lists | Baseline and 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Rehabilitation, Disability, Mobile Health Technology