Tailored implementation of a behaviour change intervention for post-stroke physical activity: A mixed-methods feasibility study

ObjectiveTo explore the feasibility of tailored implementation of a stroke physical activity behaviour change intervention (Physical Activity Routines After Stroke (PARAS)) and the feasibility of the intervention.DesignFeasibility study applying mixed methods.SettingUK stroke services.ParticipantsFour stroke rehabilitation teams comprising 34 healthcare professionals.InterventionWe applied a tailored implementation process informed by the Integrated Theory-based Framework for Intervention Tailoring Strategies to the PARAS intervention. Teams each attended two facilitated workshops (face-to-face/hybrid/online) identifying barriers and facilitators (determinants) to PARAS implementation to enable development of tailored implementation plans. Plans were applied and reviewed.Main measuresFeasibility of the tailored implementation process and intervention was explored via analysis of online questionnaire responses and thematic analysis of workshop and review session content. Inductive analysis identified determinants to implementation plan completion and enabled mapping of promising implementation strategies and their operationalisation and intervention development needs.ResultsThirty-four healthcare professionals participated across four teams. The facilitated, tailored implementation process was deemed feasible. All teams reported partially achieving implementation plans. Factors influencing implementation plan success included: motivation; stakeholder involvement; leadership and planning; intervention delivery skills. Implementation strategies mapped to factors included: assess for readiness; build a coalition; identify champions; train for leadership; and develop an implementation plan and ongoing training. Intervention adaptations identified included intervention tailoring and digitising resources.ConclusionOur implementation process and the PARAS intervention were feasible with moderate amendments. Our findings enabled development of a model to support tailored implementation of PARAS and identified intervention development needs to guide future evaluation.