Implementing a Strengths-based Intervention to Support Stroke Care Partners: Proof of Concept

Care partners experience multiple psychosocial and physiological stressors while supporting patients with stroke. We aimed to adapt an existing care partner-focused support program for skill building and psychosocial support. We sought to examine the implementation of the support program in an early-supported stroke discharge clinic and investigate the effects of the support program on care partner-reported mental health and burden. METHODS: The study followed a type 2 hybrid implementation-effectiveness design. During the implementation phases, key stakeholders evaluated and adapted the support intervention for the stroke population and completed a prospective evaluation of care partner roles in the target stroke clinic. During the intervention phase, care partners participated in the support intervention per the parent study protocol. Implementation feasibility and acceptability were evaluated, and we evaluated care partner-reported measures of physical and mental health and burden measured at baseline, 12, and 24 weeks. RESULTS: The support program was determined suitable for implementation in the target stroke clinic with a scaling-out implementation strategy. In the target stroke clinic, care partners primarily supported instrumental activities of daily living. Of 17 care partners enrolled in the support intervention, 12 completed baseline assessments. Participants who completed the intervention (n = 8) reported high satisfaction and acceptability of the program components, but some expressed concerns about the length of the surveys. Overall mental health scores increased, and burden decreased in both groups from baseline to 24 weeks. CONCLUSION: The support program adapted for care partners of patients after stroke was acceptable and feasible and has potential for benefit to physical and mental well-being and burden, though this pilot was not powered to detect significance of outcomes for participants. Scaling out may promote efficient use of limited care partner services in a health system.