The Tele-Taking Charge After Stroke Randomized Controlled Feasibility Trial (TeleTaCAS)

The Tele-Taking Charge After Stroke (TeleTaCAS) Randomized Controlled Feasibility Trial of Telehealth Take Charge vs Control

Take Charge is a novel, community-based treatment for stroke developed to harness a person's self-determination. Two prior clinical trials with 572 stroke survivors showed that Take Charge improves quality of life, independence, and social participation up to a year after stroke. Take Charge has also been shown to be overall cost-saving to the health system and is a useful adjunct to standard care after stroke.

Because of the COVID-19 pandemic, a lot of healthcare has moved into a telehealth approach. The simplicity of Take Charge may lend itself to being effective if delivered by telehealth, allowing greater access for people with stroke in rural communities. Improving the care we provide in underserved regions of the country is important to help the health of Canadians.

We are proposing a new study, working closely with the researchers who ran the previous Take Charge studies.

The goal of this feasibility clinical trial is to learn about Tele-Take Charge in adults with stroke who live in Southern Alberta. The main questions it aims to answer are:

• is delivering Take Charge by telehealth feasible?
• is Take Charge by telehealth acceptable to this population?

Participants will meet with facilitators online via Zoom at 4 to 16 weeks after stroke, and be randomized to receive either:

• two Tele-Take Charge sessions six weeks apart
• one control tele-education session.

Researchers will compare the Tele-Take Charge and control groups to see if there are any differences in outcome measures. these differences will help researchers to estimate the number of participants that will be needed for a larger, multi-centred effectiveness trial.

Study Overview

• Status: Not yet recruiting
• Conditions: Stroke/Brain Attack
• Intervention / Treatment: Other: Take Charge session; Other: Active Control

Detailed Description

For adults diagnosed with acute stroke who are discharged to community living (non-institutionalized), we wish to evaluate whether delivering two Take Charge sessions by telehealth is (1) acceptable to the population of Southern Alberta, and (2) feasible to do.

Subjects will be randomly assigned to receive either two Tele-Take Charge sessions or one tele-education session (Life After Stroke video) by telehealth (the active control).

The primary feasibility outcome will be recruitment rate. Secondary outcomes will be measured by a blinded outcomes assessor at 6 and 12 months, either by e-questionnaire or by telephone.

Those who received Tele-Take Charge will also be asked to complete an acceptability questionnaire, and will be invited to take part in an in-depth interview about their experience as part of a qualitative substudy.

• Study Type: Interventional
• Enrollment (Anticipated): 150
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Vivian WY Fu, PhD; Phone Number: 5879687352; Email: vivian.fu@ucalgary.ca
• Study Contact Backup: Name: Sean P Dukelow, PhD; Phone Number: 4038360986; Email: spdukelo@ucalgary.ca

Study Locations

• Canada
  • Calgary, Canada
    • Foothills Medical Centre
    • Contact: Vivian Fu, PhD; Phone Number: 5879687352; Email: vivian.fu@ucalgary.ca
  • Calgary, Canada
    • Dr Vernon Fanning CareWest Rehabilitation Centre
    • Contact: Team Leader / Nurse Clinician; Phone Number: 4032306900

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Discharged with diagnosis of stroke to non-institutionalised community living situation
• Answering 'No' to the question 'Are you fully recovered from your stroke?' (i.e., modified Rankin score [mRS] must be > 0)
• Able to access video calling with a smartphone, computer, or other device

Exclusion Criteria:

• Major comorbid illness that would dictate functional outcome at 12 months or life expectancy < 12 months
• Pre-stroke dependency (mRS > 2 before index stroke)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Tele-TaCAS; Two Take Charge sessions delivered by telehealth six weeks apart, the first being at 2 to 16 weeks after stroke, the earliest possible time after discharge to the community.	Other: Take Charge session; A 'talk therapy' session designed to harness the person's self-determination, re-establishing purpose, identity, autonomy, and skills to Take Charge of their recovery after stroke
Active Comparator: Control; Life After Stroke: Survivor Stories video played by telehealth at 2 to 16 weeks after stroke, the earliest possible time after discharge to the community.	Other: Active Control; Life After Stroke educational video

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of recruitment	Number of participants recruited per month	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Eligibility	Number of people meeting eligibility criteria	12 months
Treatment adherence	Number receiving both sessions	12 months
Acceptability of Tele-TaCAS	Participant acceptability questionnaire	2 weeks after receiving Tele-TaCAS
Health-related quality of life	Physical Component Summary score of the Short Form 36 The PCS of the SF-36 is a psychometrically robust measure of health-related quality of life. The score is formed from an algorithm comprising 36 questions that assess functional health and well-being from the perspective of the patient. The items contribute to eight health domains of physical functioning, role limitations due to physical problems, bodily pain, general health, vitality, social functioning, role limitations due to emotional problems and mental health. The eight domains all contribute to physical component summary (PCS) and mental component summary (MCS) scores. The minimal clinically important difference (MCID) of the PCS in stroke is estimated to be 2.5.	6 and 12 months after stroke
Independence - modified Rankin scale 0 to 2	The modified Rankin scale (mRS) is a global disability measure used commonly in acute stroke trials. The scale ranges from 0 to 6. 0 = no symptoms, 1 = able to carry out all usual activities despite symptoms, 2 = able to look after own affairs without assistance but unable to carry out all usual activities, 3 moderate disability, unable to look after own affairs but able to walk without assistance, 4 = unable to attend to own bodily needs or unable to walk without assistance, 5 = severe disability, bedridden, 6 = dead.	6 and 12 months after stroke
Activities of Daily Living - Barthel Index	The Barthel Index (BI) measures a person's current ability to do 10 different common activities with or without assistance, including bathing, walking upstairs, toileting, and feeding. The total scores range from 0 to 20, with a higher score representing more independence.	6 and 12 months after stroke
Instrumental Activities of Daily Living / Social Participation - Frenchay Activities Index	The Frenchay Activities Index (FAI) is a measure of instrumental activities of daily living that assesses a broad range of activities associated with everyday life that a patient has participated in within the recent past. These can be separated into three domains: domestic chores, leisure/work, and outdoor activities. The patient self-reports how frequently each activity was done in the prior 3-6 months, and the total score can range from 0 to 45. The higher the score, the more social participation has been reported.	6 and 12 months after stroke
Quality of Life - EQ5D5L	European Quality of Life 5 Dimension 5 Levels (EQ-5D-5L) is a self-reported measure of global quality of life in five domains and at five levels. There is also a visual analogue scale from 0 - 100 to self-rate how healthy a person feels that particular day.	6 and 12 months after stroke
Self-Determination - AMP-C	An Autonomy Mastery Purpose Connectedness score derived by our group with four statements and self-reported level of agreement on a Likert scale. Not validated but measured in the last Take Charge trial.	6 and 12 months after stroke

Collaborators and Investigators

• Sponsor: University of Calgary

Publications and helpful links

Helpful Links

• Taking Charge After Stroke main results paper

Study record dates

Study Major Dates

• Study Start (Anticipated): October 10, 2022
• Primary Completion (Anticipated): November 10, 2023
• Study Completion (Anticipated): November 10, 2023

Study Registration Dates

• First Submitted: October 17, 2022
• First Submitted That Met QC Criteria: October 17, 2022
• First Posted (Actual): October 20, 2022

Study Record Updates

• Last Update Posted (Actual): October 20, 2022
• Last Update Submitted That Met QC Criteria: October 17, 2022
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Keywords: rehabilitation; self-determination
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: Version 1.0 25Sept2022

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No