Advancing Stroke Clinical Trials Using Community Engagement and Implementation Science Approaches

Stroke clinical trials are essential for advancing stroke care but can face challenges with recruitment, retention, clinical relevance, and translation into real-world practice. We propose that integrating community engagement and implementation science approaches into stroke trials can help address these needs. We conceptualize clinical trials as an evidence-based practice and highlight that implementation frameworks linked to implementation strategies can be used to anticipate and address multilevel trial determinants. We also describe how engaging constituents across the trial lifecycle can support negotiation of inevitable trade-offs and alignment of trial decisions with the needs, capacities, and priorities of those affected, including those responsible for implementing findings. We propose that integrating community engagement and implementation science has the potential to improve trial efficiency, strengthen relevance, accelerate translation into real-world practice, and advance stroke health for all.