背景:身体活动和锻炼是保持健康的重要方面。有行动不便的人,包括中风的幸存者,运动的可能性较小,并且患慢性健康状况或恶化的风险更大。日益普及,所需的锻炼选择可以解决可用身体活动计划中的差距,提供康复后继续服务的机会,并为中风后的人和其他行动不便的人培养社会关系。针对卒中后人群的现有循证社区计划以心血管耐力为目标,移动性,行走能力,balance,和教育。虽然人们对这些项目的有效性了解很多,重要的是要了解当地环境,因为实施和维持战略是针对具体情况的。
目的:本研究方案旨在评估患有行动不便的成年人的社区需求和运动资源,最初的重点是里奇兰县的中风幸存者,南卡罗来纳州。结果将为中风幸存者提供基于证据的团体锻炼计划的混合I型有效性和实施试点。
方法:EPIS的探索和准备阶段(探索,准备工作,实施,和可持续性)实施模式指导研究。社区需求评估将通过对中风幸存者的定性半结构化访谈来评估中风幸存者的需求和愿望,康复专业人士,和健身教练为行动不便的人提供服务。将通过调查从中风幸存者那里收集其他数据。健身中心网站将通过访谈和无障碍仪器测量健身和娱乐环境清单进行评估。定性数据将使用内容分析进行评估,并得到平均调查结果的支持。数据将按社区(外部上下文)分类,潜在参与者(外部上下文),和健身中心(内部环境)并评估需求,资源,障碍,和促进者。结果将为基于证据的锻炼计划选择提供信息,适应,以及影响成功的具体本地实施策略。参与者的试验结果指标(临床有效性),process,并确定项目交付水平。将创建干预措施的实施逻辑模型,以反映试点的设计元素及其复杂的相互作用。
结果:该研究由机构审查委员会审查,并于2023年12月19日获得豁免。研究数据收集始于2024年1月,预计将于2024年6月完成。截至提交稿件,共有17名参与者接受了采访。结果预计将于2025年初公布。
结论:在社区实施需求评估之前进行需求评估,可以及早发现复杂的关系,并预先计划以解决受控有效性研究中无法预期的问题。在实施社区锻炼计划之前进行评估和准备,以增强成功的潜力,估值,并在社区中持续存在。
■DERR1-10.2196/55432。
BACKGROUND: Physical activity and exercise are important aspects of maintaining health. People with mobility impairments, including survivors of stroke, are less likely to exercise and at greater risk of developing or worsening chronic health conditions. Increasing accessible, desired options for exercise may address the gap in available physical activity programs, provide an opportunity for continued services after rehabilitation, and cultivate social connections for people after stroke and others with mobility impairments. Existing evidence-based community programs for people after stroke target cardiovascular endurance, mobility, walking ability, balance, and education. While much is known about the effectiveness of these programs, it is important to understand the local environment as implementation and sustainment strategies are context-specific.
OBJECTIVE: This
study protocol aims to evaluate community needs and resources for exercise for adults living with mobility impairments with initial emphasis on survivors of stroke in Richland County, South Carolina. Results will inform a hybrid type I effectiveness and implementation pilot of an evidence-based group exercise program for survivors of stroke.
METHODS: The exploration and preparation phases of the EPIS (Exploration, Preparation, Implementation, and Sustainment) implementation model guide the
study. A community needs assessment will evaluate the needs and desires of survivors of stroke through qualitative semistructured interviews with survivors of stroke, rehabilitation professionals, and fitness trainers serving people with mobility impairments. Additional data will be collected from survivors of stroke through a survey. Fitness center sites will be assessed through interviews and the Accessibility Instrument Measuring Fitness and Recreation Environments inventory. Qualitative data will be evaluated using content analysis and supported by mean survey results. Data will be categorized by the community (outer context), potential participants (outer context), and fitness center (inner context) and evaluate needs, resources, barriers, and facilitators. Results will inform evidence-based exercise program selection, adaptations, and specific local implementation strategies to influence success. Pilot outcome measures for participants (clinical effectiveness), process, and program delivery levels will be identified. An implementation logic model for interventions will be created to reflect the design elements for the pilot and their complex interactions.
RESULTS: The
study was reviewed by the institutional review board and exempt approved on December 19, 2023. The
study data collection began in January 2024 and is projected to be completed in June 2024. A total of 17 participants have been interviewed as of manuscript submission. Results are expected to be published in early 2025.
CONCLUSIONS: Performing a needs assessment before implementing it in the community allows for early identification of complex relationships and preplanning to address problems that cannot be anticipated in controlled effectiveness research. Evaluation and preparation prior to implementation of a community exercise program enhance the potential to be successful, valued, and sustained in the community.
UNASSIGNED: DERR1-10.2196/55432.