Implementation of Stroke Prevention Intervention Make My Day in Swedish Primary Healthcare.

Abstract

Background. Studying the implementation of occupation-based stroke prevention interventions in primary healthcare is necessary and will provide insights of interventions' feasibility in clinical practice. Purpose. To explore the implementation of the Make My Day (MMD) stroke prevention intervention in Swedish primary healthcare with health professionals (HPs) and among persons at risk for stroke. Method. The Medical Research Councils process evaluation framework domains, implementation, mechanisms of impact and context, guided investigation of the implementation. Data were collected through logbooks, fieldnotes, and interviews. Descriptive statistics were used to analyze process data while thematic analysis was applied to explore experiences of and interactions with the MMD intervention and contextual influences. Results. There was a high belief in using engaging occupations to facilitate lifestyle habit change among HP's and persons at risk for stroke. The HP's complementary competencies, sharing experiences within groups and digital self-monitoring was valued. Time constraints and age differences in groups impacted MMD delivery. Reaching a representative sample, and different Swedish primary healthcare settings was challenging. Conclusion. The occupation-based framework and intervention implementation was feasible yet sustainability in Swedish primary healthcare requires securing HP staff and time to deliver prevention like MMD, and reaching hard-to-reach groups in the study population.