Co-creating a complex intervention to increase leisure participation following stroke

Abstract

Introduction
Participation in leisure activities positively influences emotional well-being, sense of self and life expectancy. However, following stroke, two thirds of survivors experience a reduction in valued leisure activities. A recent scoping review indicates a paucity of interventions to address leisure participation post-stroke, with methodological concerns limiting valid measurement of leisure outcomes. Our study aims to co-create, with stroke survivors, carers and other stakeholders, a complex intervention to support
post-stroke leisure participation.

Methods
Medical Research Council guidance, and a participatory, inductive research design will ensure stakeholders fundamentally shape the leisure intervention development. Phase 1 (complete): Stakeholders (stroke survivors, carers, clinicians, researchers, and commissioners) participated in a consultation event (November 2023), establishing underlying principles for the Phase 2 study. Phase 2 (on-going): With consent, purposively sampled stroke survivors (n=15) and other stakeholders (n=15) will, through two independent but
interacting workstreams, define features, parameters, logistics and evaluation of this complex intervention. Data collected from stakeholder group meetings (minimum 3 in each workstream) using creative participatory techniques will be analysed using framework analysis.

Results
Phase 1 stakeholders (n=25) identified a leisure intervention should be: (1) flexible and person-centred to meet stroke survivor needs within a structured pathway; (2) available when a stroke survivor is ready; (3) collaborative across multi-agencies; (4) planned with consideration of commissioning, implementation, and sustainability. The resultant study (Phase 2) processes and outcomes will be reported.

Conclusion
The co-created intervention will be considered in the context of current provision. The next steps for evaluating the leisure intervention will be identified.