title: The development and implementation of the structured training programme for caregivers of inpatients after stroke (TRACS) intervention: the London Stroke Carers Training Course.
abstract: OBJECTIVE
  To describe the content and delivery of the adapted London Stroke Carers Training Course intervention evaluated in the Training Caregivers after Stroke (TRACS) trial.
  
  
  METHODS
  The London Stroke Carers Training Course is a structured training programme for caregivers of inpatients who are likely to return home after their stroke. The course was delivered by members of the multidisciplinary team while the patient was in the stroke unit with one recommended 'follow through' session after discharge home.
  
  
  METHODS
  The intervention consists of 14 training components (six mandatory) that were identified as important knowledge/skills that caregivers would need to be able to care for the stroke patient after discharge home. Following national training days, the London Stroke Carers Training Course was disseminated to intervention sites by the cascade method of implementation.
  
  
  RESULTS
  The intervention was adapted for implementation across a range of stroke units. Training days were well attended (median 2.5 and 2.0 attendees per centre for the first and second days, respectively) and the feedback positive, demonstrating 'face validity' for the intervention. However cascading of this training to other members of the multidisciplinary team was not consistent, with 7/18 centres recording no cascade training.
  
  
  CONCLUSIONS
  The adapted London Stroke Carers Training Course provided a training programme that could be delivered in a standardised, structured way in a variety of stroke unit settings throughout the UK. The intervention was well received by stroke unit staff, however, the cascade method of implementation was not as effective as we would have wished.
authors: Bradford Teaching Hospitals NHS Foundation Trust and University of Leeds, Bradford, UK a.forster@leeds.ac.uk.
authors: Anne
authors: A
authors: Forster
authors: Bradford Teaching Hospitals NHS Foundation Trust and University of Leeds, Bradford, UK.
authors: Josie
authors: J
authors: Dickerson
authors: Bromley Hospitals NHS Trust, Bromley, UK.
authors: Anne
authors: A
authors: Melbourn
authors: Bromley Healthcare, Bromley, UK.
authors: Jayne
authors: J
authors: Steadman
authors: Princess Royal University Hospital, Kings College Hospital NHS Trust, London, UK.
authors: Margreet
authors: M
authors: Wittink
authors: Bradford Teaching Hospitals NHS Foundation Trust and University of Leeds, Bradford, UK.
authors: John
authors: J
authors: Young
authors: King's College London, London, UK.
authors: Lalit
authors: L
authors: Kalra
authors: University of Leeds, Leeds, UK.
authors: Amanda
authors: A
authors: Farrin
mesh_terms: D000359:Aftercare / Q000379:methods* / Q000592:standards; D000488:Allied Health Personnel / Q000193:education*; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000193:education*; D006284:Health Plan Implementation / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007297:Inpatients; D008131:London; D015337:Multicenter Studies as Topic; D010351:Patient Discharge; D010564:Personnel, Hospital / Q000193:education; D016730:Program Development / Q000379:methods; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D000071939:Stroke Rehabilitation; D006113:United Kingdom
keywords: London Stroke Carers Training Course; Stroke; carer/caregiver burden; carer/caregiver training; complex intervention; rehabilitation