A telehealth intervention to promote healthy lifestyles after stroke: The Stroke Coach protocol

Abstract

Rationale Recurrent stroke is prevalent and associated with high mortality rates, disability, and social and economic costs. Adequate management of risk factors may reduce recurrent stroke; however, many stroke survivors have poor control of risk factors. We have developed a theoretically sound and evidence-based lifestyle modification program called the Stroke Coach, a telephone-based self-management program to improve control of risk factors. Hypothesis Individuals who participate in Stroke Coach will achieve more lifestyle improvements than individuals in an attention controlled Memory Training Program. Design In this single blind randomized controlled trial, 126 community-living stroke survivors will be randomized to Stroke Coach or the attention control group. Participants randomized to the six-month Stroke Coach will receive seven telephone lifestyle coaching sessions, self-management education and practice, and a self-monitoring kit, comprised of a health report card, with blood pressure and activity monitors. Study Outcomes The primary outcome will be measured using the Health Promoting Lifestyle Profile II. Secondary outcomes include behavioral and physiological risk factors, quality of life, cognitive status, health and social service use. Measurements will be taken at baseline, immediately after the intervention and six-month post-intervention. Summary The results of this trial will add to our understanding of the use of self-management to improve control of risk factors, and may facilitate the development of a larger trial evaluating the effect of Stroke Coach on endpoints such as recurrent stroke or cardiac events as the primary outcome.

Trial registration: ClinicalTrials.gov NCT02207023.

Keywords: Secondary prevention; behavior change; chronic disease management; health promotion.

Conflict of interest statement

Declaration of competing interests: None

Figures

Figure 1

Overview of trial procedures This figure presents an overview of trial procedures, outcomes, and programs being evaluated.

Figure 2

Causal behavioural modeling framework This figure presents a conceptual framework that outlines the mechanism in which behaviour change leads to improved health, as hypothesized by Stroke Coach.