Better Living After Stroke through Technology (BLAST)

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 DESCRIPTION (provided by applicant) Stroke, the leading cause of disability, cognitive impairment and death in the US, imposes significant financial and personal burden. The residual effects of stroke affect many aspects of life not addressed by traditional rehabilitation treatments. In particular, persons with mild stroke, typically defined as a stroke with no or sligh motor impairment and a high level of independence in basic activities of daily living, often experience emotional problems, subtle but significant cognitive impairment and decreased participation in productive, social and leisure activity. Despite these problems, persons with mild stroke are typically discharged to home without further referral to health or rehabilitation services other than follow-up with primary care physicians. This is a Fast-Track SBIR application based on the extensive research results from Drs. Baum and Edwards on developing and testing reliable and valid measures of activity participation (Activity Card Sort, o ACS) and cognitive skills supporting performance of simple and complex functional tasks (Functional Behavior Profile, or FBP). These measures have been used to guide treatments to help persons with mild cognitive impairment and their families support functional independence. These measures and the results of other studies will be used to build a dynamic online self-management tool designed to help persons with mild stroke develop individualized strategies that will support optimal recovery. We propose Better Living After Stroke through Technology (BLAST) to help stroke survivors and family members return back to their productive and meaningful lives by proactively 1) helping both the survivor and caregiver set their activity goals using ACS; 2) identifying and addressing the survivors behavioral/functional capabilities using FBP; 3) recognizing and managing stroke symptoms indicative of secondary stroke risks; 4) for both engaging support from online and community resources; and 5) offering tailored self-management recommendations using evidence-based strategies to help them both achieve their activity goals. Stroke survivors and caregivers using our BLAST system are expected to have better survivor self-efficacy and fewer caregiver concerns. In addition, both will have better life satisfaction and increased activity, and the stroke survivor will have better problem solving, task performance and social interaction. Specific Phase I Aims: 1) collect input from stakeholders on system features, perceived usefulness and adoption barriers via focus groups; 2) develop the Web-based mobile-friendly prototype with a user-centric design process; 3) evaluate system usability/usefulness/acceptability. Phase II Aims: 1) enhance and improve the Phase I prototype system; and 2) conduct a randomized controlled trial with 138 dyads of stroke survivors and caregivers to confirm our study hypotheses.