A tailored implementation intervention is successful in sustaining a stroke circuit class in a regional setting.

Abstract

Purpose: Guidelines recommend circuit classes to improve mobility after stroke. This study aimed to develop, deliver and evaluate an intervention to sustain a lower limb stroke circuit class in a regional setting in Australia.

Methods: This implementation study was guided by the Knowledge to Action framework with four phases. Phase 1: review of current circuit class practice. Phase 2: evaluation of health professional barriers and facilitators. Phase 3: development and delivery of a tailored implementation intervention based on the needs of health professionals. Phase 4: evaluation of sustainability and class outcomes.

Results: Phase 1: audit showed circuit classes had low attendance (n = 22/month). Phase 2: health professional participants (n = 21) identified key barriers and facilitators to delivering the circuit class, including a lack of training and confidence. Phase 3: the implementation intervention involved role modelling and training of health professionals conducting the class. Phase 4: average circuit class attendance increased and was maintained at follow-up (n = 32/month during intervention, n = 33/month post-intervention). Health professionals' confidence in others conducting the circuit class increased (43% pre-intervention to 92% post-intervention).

Conclusion: A tailored implementation intervention for health professionals in a regional community setting improved sustainability and increased confidence in conducting circuit classes for people with stroke.