Oral Presentation Smart Strokes Annual Scientific Meeting 2025

Evaluation of the Adherence Counselling Toolkit: supporting health professionals to support survivors of stroke to self-manage (125777)

Tamina Levy 1 , Elizabeth Lynch 2 , Sally Vuu 1
  1. Flinders University / Flinders Medical Centre, Unley, SA, Australia
  2. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, adelaide, SA, Australia

Introduction: 

This pilot study aimed to:

  1. Determine whether the co-designed Adherence Counselling (ACT-now) Toolkit promoted adherence to exercise in survivors of stroke in a rehabilitation setting
  2. Determine whether the ACT-now Toolkit improved self-efficacy in survivors and health professionals
  3. Identify factors influencing implementation of the ACT-now Toolkit in a health service.

Methods: The ACT-now Toolkit was implemented with survivors of stroke by health professionals (occupational therapists, exercise physiologists and physiotherapists) at Flinders Medical Centre. Thirty dyads (30 survivors and associated health professionals) received the ACT-now Toolkit intervention.

Data were collected via exercise diaries, interviews, focus groups and surveys. Self-efficacy data were collected at baseline and 1-month (Self-Efficacy for Exercise [SEE] Scale for survivors of stroke, Evidence-Based Practice Confidence Scale [EPIC] for health professionals) and analysed via t-test.

Results:

Survivors of stroke adhered to 74% of their exercise programs and significantly improved their SEE scores (pre:49.39±10.05, post:56.44±11.15, p<0.001). Health professionals’ confidence to deliver tailored exercise programs improved, but this difference was not statistically significant (EPIC; pre:70.09±14.49, post:75.72±10.39, p=0.116).

Most (91.7%) health professionals felt able to deliver the toolkit as instructed, and 92.3% found it helpful for promoting and improving physical activity. The ACT-now Toolkit was deemed feasible and acceptable, facilitated conversations, goal setting and exercise adherence. Survivors of stroke reported enhanced motivation and accountability following toolkit sessions.

Conclusion: The ACT-now Toolkit is effective for promoting exercise adherence and self-efficacy in survivors of stroke. Analysis of implementation data is guiding intervention design for a randomised controlled trial (commencing July 2025).

 Relevance to clinical practice or patient experience

  1. The ACT-now Toolkit is useful for increasing exercise adherence in inpatient and ambulatory survivors of stroke and enhanced self-efficacy, which underpins behaviour change.
  2. Health professionals found the toolkit feasible and acceptable for facilitating conversations around goal setting and exercise adherence.