title: Randomized clinical trial of the Timing it Right Stroke Family Support Program: research protocol.
abstract: BACKGROUND
  Family caregivers provide invaluable support to stroke survivors during their recovery, rehabilitation, and community re-integration. Unfortunately, it is not standard clinical practice to prepare and support caregivers in this role and, as a result, many experience stress and poor health that can compromise stroke survivor recovery and threaten the sustainability of keeping the stroke survivor at home. We developed the Timing it Right Stroke Family Support Program (TIRSFSP) to guide the timing of delivering specific types of education and support to meet caregivers' evolving needs. The objective of this multi-site randomized controlled trial is to determine if delivering the TIRSFSP across the stroke care continuum improves caregivers' sense of being supported and emotional well-being.
  
  
  METHODS
  Our multi-site single-blinded randomized controlled trial will recruit 300 family caregivers of stroke survivors from urban and rural acute care hospitals. After completing a baseline assessment, participants will be randomly allocated to one of three groups: 1) TIRSFSP guided by a stroke support person (health care professional with stroke care experience), delivered in-person during acute care and by telephone for approximately the first six to 12 months post-stroke, 2) caregiver self-directed TIRSFSP with an initial introduction to the program by a stroke support person, or 3) standard care receiving the educational resource "Let's Talk about Stroke" prepared by the Heart and Stroke Foundation. Participants will complete three follow-up quantitative assessments 3, 6, and 12-months post-stroke. These include assessments of depression, social support, psychological well-being, stroke knowledge, mastery (sense of control over life), caregiving assistance provided, caregiving impact on everyday life, and indicators of stroke severity and disability. Qualitative methods will also be used to obtain information about caregivers' experiences with the education and support received and the impact on caregivers' perception of being supported and emotional well-being.
  
  
  CONCLUSIONS
  This research will determine if the TIRSFSP benefits family caregivers by improving their perception of being supported and emotional well-being. If proven effective, it could be recommended as a model of stroke family education and support that meets the Canadian Stroke Best Practice Guideline recommendation for providing timely education and support to families through transitions.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT00958607.
authors.affiliation: Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Ave, Toronto, Ontario M5G 1V7, Canada. jill.cameron@utoronto.ca.
authors.forename: Jill I
authors.initials: JI
authors.lastname: Cameron
authors.forename: Gary
authors.initials: G
authors.lastname: Naglie
authors.forename: Monique A M
authors.initials: MA
authors.lastname: Gignac
authors.forename: Mark
authors.initials: M
authors.lastname: Bayley
authors.forename: Grace
authors.initials: G
authors.lastname: Warner
authors.forename: Theresa
authors.initials: T
authors.lastname: Green
authors.forename: Anna
authors.initials: A
authors.lastname: Czerwonka
authors.forename: Maria
authors.initials: M
authors.lastname: Huijbregts
authors.forename: Frank L
authors.initials: FL
authors.lastname: Silver
authors.forename: Steve J
authors.initials: SJ
authors.lastname: Phillips
authors.forename: Angela M
authors.initials: AM
authors.lastname: Cheung
mesh_terms: D017028:Caregivers / Q000193:education / Q000523:psychology; D006301:Health Services Needs and Demand; D006801:Humans; D008603:Mental Health; D017410:Practice Guidelines as Topic; D016037:Single-Blind Method; D012944:Social Support; D020521:Stroke / Q000628:therapy*