A tailored implementation intervention is successful in sustaining a stroke circuit class in a regional setting

Guidelines recommend circuit classes to improve mobility after stroke. This study aimed to develop, deliver and evaluate an intervention to sustain a lower limb stroke circuit class in a regional setting in Australia. This implementation study was guided by the Knowledge to Action framework with four phases. Phase 1: review of current circuit class practice. Phase 2: evaluation of health professional barriers and facilitators. Phase 3: development and delivery of a tailored implementation intervention based on the needs of health professionals. Phase 4: evaluation of sustainability and class outcomes. Phase 1: audit showed circuit classes had low attendance (<i>n</i> = 22/month). Phase 2: health professional participants (<i>n</i> = 21) identified key barriers and facilitators to delivering the circuit class, including a lack of training and confidence. Phase 3: the implementation intervention involved role modelling and training of health professionals conducting the class. Phase 4: average circuit class attendance increased and was maintained at follow-up (<i>n</i> = 32/month during intervention, <i>n</i> = 33/month post-intervention). Health professionals’ confidence in others conducting the circuit class increased (43% pre-intervention to 92% post-intervention). A tailored implementation intervention for health professionals in a regional community setting improved sustainability and increased confidence in conducting circuit classes for people with stroke. The Theoretical Domains Framework (TDF) and a survey based on the NoMAD are successful in identifying barriers and facilitators for health professionals conducting circuit classes in a regional community settingA tailored implementation intervention improved health professionals’ confidence in conducting circuit classesConducting circuit classes is sustainable in a regional community setting The Theoretical Domains Framework (TDF) and a survey based on the NoMAD are successful in identifying barriers and facilitators for health professionals conducting circuit classes in a regional community setting A tailored implementation intervention improved health professionals’ confidence in conducting circuit classes Conducting circuit classes is sustainable in a regional community setting