Selection of Implementation Strategies for a Self-guided, Digital Return-to-Work Toolkit for Employers and Stroke Survivors

Abstract Stroke incidence among working-age adults is increasing. Many experience barriers when returning to work and have limited access to vocational rehabilitation. Digital health interventions may enhance rehabilitation provision, yet their implementation strategies are poorly reported. This study aimed to identify and describe strategies to support implementation of a self-guided, digital return-to-work toolkit for employers and stroke survivors. The study sought to explore employers’ perspectives on factors influencing toolkit implementation, map findings onto the Theoretical Domains Framework, apply the StrategEase tool to identify strategies, and refine strategy selection through stakeholder consultation. Interviews were conducted with seven employers to explore influential factors. A survey of 50 employers included an open-ended item on implementation. Qualitative data were synthesised and mapped onto the Theoretical Domains Framework. The StrategEase tool was used to identify implementation strategies. The strategies were refined through feedback from an employer workshop and advisory group meeting. Influential factors were identified at multiple levels, including user beliefs about consequences, workplace resources, and length of vocational rehabilitation pathways within the healthcare system. Selected strategies included staff meetings and briefings, policy and guidance changes, educational materials and sessions, mandating change, accreditation, and development of a network of toolkit users. The StrategEase tool was easy to apply. Its tailored approach may enhance the implementation and impact of interventions. Further research is needed to (a) inform the toolkit’s implementation, involving diverse stakeholders, (b) investigate the effectiveness of implementation strategies, and (c) investigate the StrategEase tool’s applicability and effectiveness in other contexts.