JMIR Publications

ABSTRACT

Background:

A global trend is to move rehabilitation closer to people's neighbourhoods and homes. Still, little attention has been given to how the built environment outside the hospital setting might impact rehabilitation and recovery for stroke survivors.

Objective:

The overarching objective of this project is to develop conceptual models of built environments that support stroke rehabilitation and recovery outside the hospital setting. Specifically, the project will explore factors and characteristics of the built environment that support people with stroke and their families and identify innovative built environments that can be designed for local healthcare. The project will examine facilitators and obstacles for implementing built environmental solutions and evaluate the potential benefits, feasibility, and acceptability.

Methods:

The project uses a mixed-method design approach with three phases. In phase one, factors and characteristics of the built environment for rehabilitation will be identified. Based on the results from phase one, phase two will involve co-designing prototypes of environments to support the rehabilitation process for people with stroke. Finally, the prototypes will be evaluated in phase three. Qualitative and quantitative methods will include a literature review, a concept mapping study, stakeholder interviews, prototype development, and testing. The project will use multidimensional scaling, hierarchical cluster analysis, descriptive statistics for quantitative data, and content analysis for qualitative data. Location analysis will rely on the location-allocation model for network problems, and the rule-based analysis will be based on geographic information systems data.

Results:

As of the submission of this protocol, ethical approval for the concept mapping study and the interview study has been obtained. Data collection is planned to start in September 2023 and the workshops later the same year. The scoping review is ongoing from January 2023. The concept mapping study is ongoing and will be finalized spring 2024. We expect to finish the data analysis in the second half of 2024.The project is a three-year project and will continue until December 2025.

Conclusions:

We aim to determine how new environments could better support a person’s control over their day, environment, goals, and ultimately control over their recovery and rehabilitation activities. This ‘taking charge’ approach would have the greatest chance of transferring the care closer to the patient's home. By co-designing with multiple stakeholders, we aim to create solutions with the potential for rapid implementation. The project’s outcomes may target other persons with frail health after a hospital stay or older persons in Sweden and elsewhere. The impact and social benefits include: collaboration between important stakeholders to explore how new environments can support the transition to local healthcare, co-design and test of new conceptual models of environments that can promote health and well-being for people post-stroke. Clinical Trial: No