A telehealth intervention to promote healthy lifestyles after stroke: The Stroke COACH

Stroke is often associated with low levels of physical activity and poor nutrition habits and with related conditions such as obesity, hypertension and diabetes. Within five years of the initial stroke, 30 percent of stroke survivors will suffer a recurrent stroke.

We developed the telehealth Stroke COACH programme, a lifestyle modification intervention comprised of a self-management manual for stroke survivors, a self-monitoring kit (including a blood pressure monitor, pedometer, and health report card), and telephone-coaching sessions by trained ‘lifestyle coaches’. In this six month program, seven sessions of 30-60 minutes are delivered by the coaches who use motivational interviewing techniques to facilitate active patient engagement and enhance chronic disease self-management skills of problem solving, decision making, action planning, and resource utilization.

One hundred twenty-five community-dwelling individuals who have had a stroke of mild to moderate severity within the last twelve months will be enrolled in this single-blind randomized controlled trial. They will be randomly assigned to either: 1) Stroke COACH with a lifestyle coach, or 2) control group (memory training program with a memory coach).

We predict that the Stroke COACH will improve a global measure of lifestyle behaviour in community-dwelling stroke survivors compared to the control group. This will be measured at zero, six, and 12 months using the Lifestyle Profile II, a global lifestyle behaviour measure that considers physical activity, stress management, nutrition, health advocacy, interpersonal support, and spirituality.

We also predict improvement in physical activity and cardiovascular health outcomes, which we will measure using the StepWatch Activity Monitor and bloodwork results.

If testing is successful, the low-cost and remote delivery of the Stroke COACH would enable a large number of Canadians in both urban and rural regions to improve health behaviours of people living with stroke, potentially reducing the risk of subsequent stroke.