Capability, opportunity, motivation, and social participation after stroke

ABSTRACT

Background

Stroke survivors report limited social participation, despite it being an important rehabilitation outcome. Interdisciplinary interventions for increasing social participation amongst stroke survivors lack theoretical guidance and evidence-based approaches. The Behavior Change Wheel (BCW) theorizes that capability, opportunity, and motivation contribute to behavior change.

Objectives

This study applied the BCW to understand the relationship between social participation and stroke survivors’ capability, opportunity, and motivation.

Methods

In this cross-sectional study, we recruited 30 community-dwelling adult stroke survivors. Assessments explored the frequency and satisfaction of social participation; physical and psychological capability; environmental accessibility and social opportunity; and motivation. A linear regression analysis was done.

Results

Motivation (R² change = 29.3%, ß = 0.55) and environmental opportunity (R² change = 11%, ß = 0.39) were statistically significant predictors of social participation frequency. Motivation (R² change = 36.9%, ß = 0.61) was the only statistically significant predictor of satisfaction with social performance.

Conclusions

Motivation and environmental accessibility are statistically significant independent predictors of frequency of social participation after stroke. Motivation is the strongest predictor of satisfaction with social participation. Clinicians may support stroke survivors to promote social participation using approaches that increase motivation and environmental accessibility. Development of such theoretically sound interventions may be guided by the BCW.

KEYWORDS:

• Cerebrovascular accident
• acquired brain injury
• rehabilitation
• social participation
• COM-B

Acknowledgments

Michael Smith Foundation for Health Research for a Scholar Award to BMS.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Nicole Gingrich

Nicole Gingrich works as an occupational therapist at a rehabilitation center in Vancouver, BC, Canada.

Jacob Bosancich

Jacob Bosancich works as an occupational therapist at a rehabilitation center in Vernon, BC, Canada.

Julia Schmidt

Julia Schmidt is an Assistant Professor in the Department of Occupational Science and Occupational Therapy at The University of British Columbia.

Brodie M. Sakakibara

Brodie Sakakibara is an Assistant Professor in the Department of Occupational Science and Occupational Therapy, and an Investigator at the Centre for Chronic Disease Prevention and Management at The University of British Columbia.