Stroke Survivors’ and Caregiver’s Experiences of and Perspectives on Utilizing Outdoor Exercise Facilities and Park Space for Self-Managed Rehabilitation: A Multi-Method Qualitative Study

In Hong Kong, stroke is the leading cause of long-term disability. However, after one-year post-stroke, professional rehabilitation services are not typically provided by the public healthcare system, leaving stroke survivors to rely on themselves and their caregivers for long-term rehabilitation. Interestingly, it has been observed that some stroke survivors and their caregivers in Hong Kong utilize outdoor exercise facilities in parks to self-manage their long-term rehabilitation. Given that outdoor exercise facilities and the exercise spaces were not originally designed for rehabilitation purposes, there has been a lack of research on their use for post-stroke self-managed rehabilitation. There is much to be learned about how some stroke survivors and their caregivers utilize these outdoor exercise facilities and spaces for rehabilitation and health maintenance and which facilitating elements of outdoor exercise equipment and exercise space design in parks could better support them in the future. The proposed project will seek to bridge this knowledge gap through a multi-method qualitative study. Go-along interviews and participatory design model-making focus groups will be used to investigate the topic. Go-along interviews allow both researchers and participants engaging in place-informed discussion in the physical socio-spatial environment of interest, providing opportunities for researcher to delve into participants’ routine and experiences. And participatory design model-making is an activity that encourages non-designer participants to give concrete inputs about a topic through tools like models and sticky notes. We plan to apply a maximum variation sampling strategy and recruit approximately 40 participants, comprising 20 stroke survivor–caregiver dyads, with stroke survivors having low-to-slight levels of disability and at least a moderate level of disability. Researchers will conduct go-along interviews with stroke survivor-caregiver dyads in public parks to understand their long-term self-managed rehabilitation and health maintenance experiences. To identify elements of outdoor exercise equipment and exercise space design in parks that could enhance stroke survivors’ and their caregivers’ experiences in parks, the researcher will conduct participatory design model-making focus group interviews with the dyads. Both data collection and analysis will be underpinned by an explorative–descriptive qualitative theoretical approach with the aim to provide pragmatic insights to healthcare and design discipline. This project initiates the critical first step to investigate in-depth the phenomenon of how the biggest disability group and their caregivers negotiate with the outdoor exercise facilities in parks for self-managed rehabilitation and what could be done to better support them in healthcare and park design in the future.