A New At-home Telerehabilitation Care Service Delivery Model for Stroke Survivors in the Rio Grande Valley

The University of Texas Health Science Center, Houston30 enrolled

Overview

The purpose of this study is to investigate the feasibility of a mobile telerehabilitation software for post-acute stroke care for Rio Grande Valley (RGV) stroke survivors with community health worker (CHW) at-home support and to estimate the functional health, mental health (depression), and caregiver burden outcomes of this new CHW-supported, at-home rehabilitation service delivery model and to identify salient barriers to and facilitators of adopting and delivering the new rehabilitation delivery model to further disseminate the model in real-world communities.

Study Type

INTERVENTIONAL

Allocation

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Stroke

Interventions

CHW-supported telerehabilitation

Participants will receive the Mobile Rehab mobile software, which allows participants to be prescribed personalized rehabilitation strengthening video regimens electronically based on respondent-indicated mobility and activities of daily living functionality

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * A resident of the Brownsville, Texas (Cameron County) area * SINGLE and FIRST qualifying stroke event with the ability to enroll and begin study activities within 3 months of onset of stroke event * Pre-stroke modified Rankin score of ≤3 (less than moderate disability at baseline) * Currently uninsured * Spanish or English speaker * Able to follow instructions (without aphasia that interferes with following instructions) * Safe to perform basic strengthening rehabilitation exercises * Able to stand with or without assistance Exclusion Criteria: * Aphasia or cognitive impairment (e.g., dementia) that interferes with following instructions or prevents following the study-related activities) * Pre-stroke motor deficits * Current psychiatric disorders, including substance use disorder * Underlying brain pathologies inclusive of brain malignancies, multiple sclerosis * Insured patients as insured patients are referred for standard-of-care clinical rehabilitation. * Medical instability to participate in basic strengthening rehabilitation exercises * Inability to access internet from home to access at-home rehabilitation software for intervention arm participants * Having received any outpatient rehabilitation services prior to study enrollment for intervention arm participants

Outcomes

Primary Outcomes

Change in basic mobility as assessed by the Acute Measure for Post-Acute Care (AM-PAC) Basic Mobility Outpatient Form (routine)

This is an 18 item questionnaire and each is scored from 1(unable) to 4( none) for a score range of 1-72, higher score indicating better outcome

Time frame: Baseline (week 1), week 3 (intervention participants only), week 6

Change in basic mobility as assessed by the Acute Measure for Post-Acute Care (AM-PAC) Basic Mobility Outpatient Form (low function )

This is a 19 item questionnaire and each is scored from 0(unable) to 3( none) for a score range of 0-57, higher score indicating better outcome

Time frame: Baseline (week 1), week 3 (intervention participants only), week 6

Change in basic activity as Acute Measure for Post-Acute Care (AM-PAC) Daily Activity Outpatient Short Form (routine)

This is a 15 item questionnaire and each is scored from 1(unable) to 4( none) for a score range of 1-60, higher score indicating better outcome

Time frame: Baseline (week 1), week 3 (intervention participants only), week 6

Change in basic activity as Acute Measure for Post-Acute Care (AM-PAC) Daily Activity Outpatient Short Form (low function)

This is a 12 item questionnaire and each is scored from 0(total) to 3( none) for a score range of 1-36, higher score indicating better outcome

Time frame: Baseline (week 1), week 3 (intervention participants only), week 6

Change in Health-related quality of life as assessed by the European Health-Related Quality of Life- 5 Dimensions (EQ-5D) EuroQoL-5D five-level survey (EQ-5D-5L)

This is scored across 5 dimensions , mobility, self-care, usual activities, pain/discomfort, and anxiety/depression and each dimension is scored on a five-level severity ranking that ranges from 1 (no problems) to 5 (extreme problems), higher score indicating worse outcome

Time frame: Baseline, week 3 (intervention participants only), week 6

Change in Depression as assessed by the Patient Health Questionnaire 9 (PHQ-9)

This is a 9 item questionnaire and each is scored from 0(not at all) to 3(nearly every day) for a score range of 0-27, higher score indicating worse outcome

Time frame: Baseline, week 3 (intervention participants only), week 6

Change in caregiver burden as assessed by the Zarit Burden Interview

This is a 12 item questionnaire and each is scored from 0(never) to 4(nearly always) for a score range of 0-48, higher score indicating worse outcome

Time frame: Baseline, week 3 (intervention participants only), week 6

Secondary Outcomes

Acceptability/Appropriateness of the intervention for the stroke survivors as assessed by the Quantitative Implementation Measures for Stroke Survivors questionnaire

This is an 8 item questionnaire and each is scored from 1( strongly disagree) to 5(strongly agree) for a score range of 1-40, higher score indicating better outcome

Time frame: Baseline

Acceptability/Appropriateness of the intervention for the stroke survivors as assessed by the Quantitative Implementation Measures for Stroke Survivors questionnaire

This is an 8 item questionnaire and each is scored from 1( strongly disagree) to 5(strongly agree) for a score range of 1-40, higher score indicating better outcome

Time frame: week 7

Adoption of the intervention for the stroke survivors as assessed by the Quantitative Implementation Measures for Stroke Survivors questionnaire

This is an 5 item questionnaire and each is scored from 1( strongly disagree) to 5(strongly agree) for a score range of 1-25, higher score indicating better outcome

Time frame: Baseline

Adoption of the intervention for the stroke survivors as assessed by the Quantitative Implementation Measures for Stroke Survivors questionnaire

This is an 5 item questionnaire and each is scored from 1( strongly disagree) to 5(strongly agree) for a score range of 1-25, higher score indicating better outcome

Time frame: week 7

Acceptability & Appropriateness of the intervention for the community health workers as assessed by the Quantitative Implementation Measures for Community Health Worker questionnaire

This is an 7 item questionnaire and each is scored from 1( strongly disagree) to 5(strongly agree) for a score range of 1-35, higher score indicating better outcome

Time frame: Baseline

Acceptability & Appropriateness of the intervention for the community health workers as assessed by the Quantitative Implementation Measures for Community Health Worker questionnaire

Adoption of the intervention for the community health workers as assessed by the Quantitative Implementation Measures for Community Health Worker questionnaire

This is an 4 item questionnaire and each is scored from 1( strongly disagree) to 5(strongly agree) for a score range of 1-20, higher score indicating better outcome

Time frame: Baseline

Adoption of the intervention for the community health workers as assessed by the Quantitative Implementation Measures for Community Health Worker questionnaire

This is an 4 item questionnaire and each is scored from 1( strongly disagree) to 5(strongly agree) for a score range of 1-20, higher score indicating better outcome

Time frame: week 7

Feasibility of Community Health Worker as assessed by the Quantitative Implementation Measures for Community Health Worker questionnaire

This is an 7 item questionnaire and each is scored from 1( strongly disagree) to 5(strongly agree) for a score range of 1-35, higher score indicating better outcome

Time frame: Baseline

Feasibility of Community Health Worker as assessed by the Quantitative Implementation Measures for Community Health Worker questionnaire

This is an 7 item questionnaire and each is scored from 1( strongly disagree) to 5(strongly agree) for a score range of 1-35, higher score indicating better outcome

Time frame: week 7 (immediately after intervention)

Adherence as assessed by the number of rehab videos watched in a day

adherence is defined by ≥1 daily mobile rehab video usage

Time frame: end of study (week 7)

A New At-home Telerehabilitation Care Service Delivery Model for Stroke Survivors in the Rio Grande Valley

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts