Assessing a Stroke Homehealth Aide Recovery Program (SHARP) as a Potential High Impact Strategy for Improving in Functional Mobility after Stroke

项目摘要 该项目的总体目标是改善中风患者的功能。该项目将试点测试一个 创新的中风家庭健康援助恢复计划（SHARP），旨在改善流动性和减少福尔斯 在急性期后的居家中风患者中。夏普将通过扩大家庭为基础的 康复团队，包括一个先进的家庭健康助理（HHA）专门培训， “教练”教练将采用“培训教练”的方法来培训和支持通才HHA 因为他们与病人和家属合作，实施病人处方的治疗方案， 医生和康复治疗师。试点研究将聘请和培训10名经验丰富的家庭保健 助手成为SHARP教练，并将随机分配60名同意，符合条件的患者参加SHARP 干预组（30）或接受常规护理的对照组（30）。这项研究的具体目标是： 测试目标1：测试SHARP招募和随机化程序，特别是识别， 招募并完成10名SHARP教练的培训，并有能力识别、招募和完成 对60名中风后患者进行干预和数据收集活动。 目标2：评估SHARP指导计划对教练/直接护理HHA/患者的可接受性。 康复治疗师和征求反馈，以确定调整，可能需要在未来 通过访谈或焦点小组与每个参与小组的成员进行试验。 目标3：通过以下方式评估SHARP计划干预组件的实施保真度： 监测预期教练访问的及时性和完成情况，维护锻炼日志，以及其他 礼宾活动。 目标4：检查选定基线、主要 通过基线和60天随访访谈进行次要结局测量，以供考虑 一项更大规模的SHARP有效性研究的结果。 SHARP是一种潜在的劳动力发展解决方案，用于解决最大化中风的国家优先事项 患者恢复完整和独立生活的能力和可能性。夏普将创造一个新的类别 专门为中风后康复和成人学习准备的有文化能力的高级HHA， 加强居家康复。该模型将扩大HHA在促进患者功能性 活动能力、降低福尔斯跌倒风险、提高对可能的中风后抑郁症的认识并改善患者的生活质量 生活质量SHARP模型有可能成为一个高影响力的方法，以加强家庭为基础的 中风后康复和改善功能性活动能力，定义为个人在其活动范围内活动的能力 环境，以实现日常生活活动。

Project Summary The overall goal of this project is to improve patients’ function following stroke. The project will pilot test an innovative Stroke Homehealth Aide Recovery Program (SHARP) designed to improve mobility and reduce falls in post-acute homebound stroke patients. SHARP would accomplish this by expanding the home-based rehabilitation team to include a corps of advanced home health aides (HHAs) specially trained as stroke “coaches.” The coaches will in turn employ a “train-the-trainer” approach to train and support generalist HHAs as they collaborate with patients and families to implement the therapeutic regimens prescribed by patients’ physicians and rehabilitation therapists. The pilot study will engage and train 10 experienced home health aides to become SHARP coaches and will randomly assign 60 consented, eligible patients to the SHARP intervention (30) or a control group (30) receiving usual care. The specific aims of the study are to:  Aim 1: Test SHARP recruitment and randomization procedures, specifically the ability to identify, recruit and complete training of 10 SHARP coaches and the ability to identify, recruit and complete intervention and data collection activities with 60 post-stroke patients.  Aim 2: Assess the acceptability of the SHARP coaching program to coaches/direct care HHAs/patients/ rehabilitation therapists and solicit feedback to determine adjustments that may be needed in a future trial through interviews or focus group with members of each of the participating groups.  Aim 3: Assess implementation fidelity to the SHARP program intervention components through monitoring the timeliness and completion of expected coach visits, exercise log maintenance, and other protocol activities.  Aim 4: Examine patient response burden and psychometric properties of selected baseline, primary and secondary outcome measures through baseline and 60 day follow-up interviews for consideration of a subsequent larger scale study of SHARP effectiveness. SHARP is a potential workforce development solution for addressing the national priority of maximizing stroke patients’ abilities and likelihood of returning to a full and independent life. SHARP would create a new category of culturally competent advanced HHAs specially prepared in post-stroke rehabilitation and adult learning to enhance home-based rehabilitation. The model would expand the HHAs’ role in promoting patients’ functional mobility, reducing risk of falls, improving recognition of possible post-stroke depression and improving patients’ quality of life. The SHARP model has the potential to be a high impact approach to enhancing home-based post-stroke rehabilitation and improving functional mobility, defined as individuals’ capacity to move within their environment to achieve activities of daily living.