Creating an appropriate adaptation of a healthy lifestyle intervention for people after stroke

ABSTRACT

Primary Objective

To describe (1) an evidence-based approach to promoting a healthy lifestyle, the Diabetes Prevention Program Group Lifestyle Balance intervention, and (2) our work with input from an Advisory Board of stakeholders to modify the program to meet the unique needs of people post stroke.

Research Design

Community-Based Participatory Research

Methods and Procedures

An Advisory Board of stakeholders was convened to modify the Group Lifestyle Balance intervention to meet the unique needs of people post stroke.

Main Outcomes and Results

The primary adaptations that emerged from the Advisory Board included (1) curriculum emphasis on heart health after stroke, (2) care partner participation, (3) physical activity, dietary, and weight loss modifications specific to people after stroke, and (4) general programmatic recommendations (e.g., wider age range of participants; eligibility based on time since stroke; alternative modes of delivery).

Conclusions

Feedback from the diverse group of stakeholders provides the basis for modifying an evidence-based healthy lifestyle intervention to meet the unique needs of people after stroke. Future research efforts should examine the efficacy and effectiveness of the adapted program to prevent weight gain after stroke and reduce the risk of chronic conditions including diabetes, metabolic syndrome, and heart disease.

KEYWORDS:

• Cerebrovascular accident
• weight loss
• exercise

Acknowledgments

The authors would like to thank the Advisory Board for their expertise, time, and thoughtfulness in making recommendations on modifications. The authors would also like to acknowledge the Diabetes Prevention Support Center (DPSC) at the University of Pittsburgh for training, assistance with curriculum adaptation, and ongoing support in the Group Lifestyle Balance programme. Finally, we acknowledge the complementary and concurrent qualitative work of Ryan Bailey and Jennifer Stevenson in using focus groups to identify appropriate modifications to the DPP-GLB for adults with stroke.

Declaration of interest

The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

Additional information

Funding

The contents of this manuscript were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90IFRE0021). NIDILRR is a center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS).