title: Study protocol of the YOU CALL--WE CALL TRIAL: impact of a multimodal support intervention after a "mild" stroke.
abstract: BACKGROUND
  More than 60% of new strokes each year are "mild" in severity and this proportion is expected to rise in the years to come. Within our current health care system those with "mild" stroke are typically discharged home within days, without further referral to health or rehabilitation services other than advice to see their family physician. Those with mild stroke often have limited access to support from health professionals with stroke-specific knowledge who would typically provide critical information on topics such as secondary stroke prevention, community reintegration, medication counselling and problem solving with regard to specific concerns that arise. Isolation and lack of knowledge may lead to a worsening of health problems including stroke recurrence and unnecessary and costly health care utilization.The purpose of this study is to assess the effectiveness, for individuals who experience a first "mild" stroke, of a sustainable, low cost, multimodal support intervention (comprising information, education and telephone support)--"WE CALL" compared to a passive intervention (providing the name and phone number of a resource person available if they feel the need to)--"YOU CALL", on two primary outcomes: unplanned-use of health services for negative events and quality of life.
  
  
  METHODS
  We will recruit 384 adults who meet inclusion criteria for a first mild stroke across six Canadian sites. Baseline measures will be taken within the first month after stroke onset. Participants will be stratified according to comorbidity level and randomised to one of two groups: YOU CALL or WE CALL. Both interventions will be offered over a six months period. Primary outcomes include unplanned use of heath services for negative event (frequency calendar) and quality of life (EQ-5D and Quality of Life Index). Secondary outcomes include participation level (LIFE-H), depression (Beck Depression Inventory II) and use of health services for health promotion or prevention (frequency calendar). Blind assessors will gather data at mid-intervention, end of intervention and one year follow up.
  
  
  CONCLUSIONS
  If effective, this multimodal intervention could be delivered in both urban and rural environments. For example, existing infrastructure such as regional stroke centers and existing secondary stroke prevention clinics, make this intervention, if effective, deliverable and sustainable.
  
  
  BACKGROUND
  ISRCTN95662526.
authors.affiliation: Montreal University, Montreal, Quebec, Canada. annie.rochette@umontreal.ca
authors.forename: Annie
authors.initials: A
authors.lastname: Rochette
authors.forename: Nicol
authors.initials: N
authors.lastname: Korner-Bitensky
authors.forename: Duane
authors.initials: D
authors.lastname: Bishop
authors.forename: Robert
authors.initials: R
authors.lastname: Teasell
authors.forename: Carole
authors.initials: C
authors.lastname: White
authors.forename: Gina
authors.initials: G
authors.lastname: Bravo
authors.forename: Robert
authors.initials: R
authors.lastname: Côté
authors.forename: Jean
authors.initials: J
authors.lastname: Lachaine
authors.forename: Teri
authors.initials: T
authors.lastname: Green
authors.forename: Louise-Hélène
authors.initials: LH
authors.lastname: Lebrun
authors.forename: Sylvain
authors.initials: S
authors.lastname: Lanthier
authors.forename: Moira
authors.initials: M
authors.lastname: Kapral
authors.forename: Sharon
authors.initials: S
authors.lastname: Wood-Dauphinee
mesh_terms: D002170:Canada; D002985:Clinical Protocols; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012107:Research Design; D020521:Stroke / Q000453:epidemiology; D000071939:Stroke Rehabilitation; D017216:Telemedicine / Q000379:methods*; D013689:Telephone; D013997:Time Factors; D016896:Treatment Outcome