Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Jul 14, 2023
Date Accepted: Jan 15, 2024
Digital Intervention to Promote Self-management Self-efficacy among Community-dwelling Individuals with Stroke: A Feasibility Study
ABSTRACT
Background:
Digital interventions provided via smartphones or the Internet, guided by a coach, have been proposed as promising solutions to support the self-management (SM) of chronic conditions. However, digital intervention for post-stroke self-management is limited; we developed the interactive Self-Management augmented by Rehabilitation Technologies (iSMART) to address this gap.
Objective:
This study aimed to examine the feasibility and initial effects of the iSMART to improve self-management self-efficacy in people with stroke.
Methods:
We conducted a randomized controlled trial with 24 participants with mild-to-moderate chronic stroke. Participants were randomized to receive three months of the iSMART or to an attention control group. The iSMART is a coach-guided, technology-supported self-management intervention targeting to support people to manage chronic conditions and maintain active participation in daily life participation after stroke. Feasibility measures include the Feasibility of Intervention Measure (FIM), Acceptability of Intervention Measure (AIM), and Intervention Appropriateness Measure (IAM). Health measures include the Participation Strategies Self-Efficacy Scale (PS-SES) and PROMIS Self-Efficacy for Managing Chronic Conditions (PROMIS-SE).
Results:
FIM, AIM, and IAM mean scores were 4.11 (SD = .61), 4.44 (SD = .73), and 4.36 (SD= .70), respectively, which exceeded our benchmark (4 out of 5), suggesting high feasibility, acceptability, and appropriateness of the iSMART. The iSMART group showed moderate to large effects in improving self-efficacy in managing symptoms (d = .514), daily activities (d = .593), and treatments and medications (d = .870). The iSMART also showed moderate effects in improving self-efficacy in using participation strategies for home (d = .554), community (d = .673), and work activities (d = .633).
Conclusions:
Preliminary results suggest the iSMART intervention is feasible, acceptable, and appropriate for improving self-efficacy in managing symptoms, daily activities, and treatments, as well as using participation strategies to support home, work, and community activities in people with stroke. Clinical Trial: ClinicalTrials.gov ID: 202004137
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