title: Bridges self-management program for people with stroke in the community: A feasibility randomized controlled trial.
abstract: BACKGROUND
  Enabling self-management behaviors is considered important in order to develop coping strategies and confidence for managing life with a long-term condition. However, there is limited research into stroke-specific self-management interventions.
  
  
  OBJECTIVE
  The aim of this randomized controlled trial was to evaluate the feasibility of delivering the Bridges stroke self-management program in addition to usual stroke rehabilitation compared with usual rehabilitation only.
  
  
  METHODS
  Participants recruited from the referrals to a community stroke team were randomly allocated to the Bridges stroke self-management program, receiving either one session of up to one-hour per week over a six-week period in addition to usual stroke rehabilitation, or usual rehabilitation only. Feasibility was measured using a range of methods to determine recruitment and retention; adherence to the program; suitability and variability of outcome measures used; application and fidelity of the program; and acceptability of the program to patients, carers and professionals.
  
  
  RESULTS
  Twenty-five people were recruited to the study over a 13-month period. Eight out of the 12 participants in the Bridges stroke self-management program received all six sessions; there was one withdrawal from the study. There were changes in outcomes between the two groups. Participants who received the Bridges stroke self-management program appeared to have a greater change in self-efficacy, functional activity, social integration and quality of life over the six-week intervention period and showed less decline in mood and quality of life at the three-month follow-up. Professionals found the program acceptable to use in practice, and feedback from participants was broadly positive.
  
  
  CONCLUSIONS
  The findings from this study appear promising, but questions remain regarding the feasibility of delivering the Bridges stroke self-management program in addition to usual rehabilitation. The dose response of receiving the program cannot be ruled out, and the next stage of research should explore the feasibility of an integrated program. Exploration of the reasons behind relatively low recruitment and of the sensitivity of outcome measures to detect a change are also required. Additional investigation of intervention fidelity is required to monitor if the program is being delivered as intended.
authors.affiliation: School of Health Sciences, Health and Rehabilitation Sciences Research Centre, University of Ulster, Newtownabbey, UK.
authors.forename: Suzanne
authors.initials: S
authors.lastname: McKenna
authors.affiliation: Faculty of Health & Social Care, St George's University of London and Kingston University, London, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Jones
authors.affiliation: Community Stroke Team, South Eastern Health and Social Care Trust, Bangor, UK.
authors.forename: Pauline
authors.initials: P
authors.lastname: Glenfield
authors.affiliation: School of Health Sciences, Health and Rehabilitation Sciences Research Centre, University of Ulster, Newtownabbey, UK.|Physiotherapy, School of Medicine, Flinders University, Adelaide, Australia.
authors.forename: Sheila
authors.initials: S
authors.lastname: Lennon
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D012111:Residence Characteristics; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D055815:Young Adult
keywords: behavioral intervention; chronic disease; clinical trial; feasibility; self-management; stroke