Abstract NS1: Mobile Health Technology Is Feasible And Effective For Self-management Support Among Underserved Stroke Survivors

Background and Purpose: Self-management Support (SMS) helps stroke survivors control risk factors to prevent second stroke. Little is known about feasibility and effectiveness of using mobile health technology (MHT) for SMS among underserved stroke survivors. The investigators studied feasibility and effectiveness of using a video teleconference mobile application to deliver a SMS program to underserved, hard to reach stroke survivors. Methods: The Video teleconference Self-management TO Prevent stroke (V-STOP) program was evaluated using longitudinal design with measurements at baseline, immediately post intervention (6 weeks), intermediate (12 weeks), and at study end (18 weeks). Medically underserved stroke survivors with uncontrolled stroke risk factors were included. Feasibility was assessed as time in intervention, telehealth satisfaction, stroke knowledge and SMS effectiveness were measured as psychological (depression, PHQ-8; anxiety, GAD-7), social (community integration questionnaire), and stroke self-management (goal attainment) outcomes. Generalized estimating equations were used with site and time in intervention as covariates. Results: V-STOP was successfully delivered to 106 participants using MHT over 2 years. Mean age was 59.3 (±10.9), majority were white (82.1%), males (54.3%), not living alone (85.9%), married (52.8%), with low annual income (<$25,000) ( 58.5%), and health insurance (59.4%). Program feasibility indicated mean number of V-STOP sessions were 4.6 (±1.8), with 4.4 (±2.0) hours of total time for the intervention. Overall satisfaction at 6 weeks with V-STOP (4.8(±0.5)) and telehealth (4.7(±0.5)) was high. Stroke knowledge was high at 12 weeks (9.6(±0.7)). SMS effectiveness indicated improvement in psychological outcomes at 6, 12, and 18 weeks from baseline; depression (18 weeks - β = 0.64 (CI 0.49-0.84)) and anxiety (18 weeks - β = 0.66 (CI 0.51-0.85)). Community integration improved by 18 weeks - β = 1.08 (CI 1.01-1.16) and stroke self-management also improved long term at 12 and 18 weeks (β = 0.92 (CI 0.84-0.99). Conclusion: MHT is feasible to deliver SMS to underserved stroke survivors. It improves psycho-social and self-management goal setting and goal attainment outcomes.

A Scoping Review of Interventions Delivered by Peers to Support the Resettlement Process of Refugees and Asylum Seekers

The aim of this scoping review is to conduct a systematic search of the literature as it pertains to interventions delivered by peers to refugees and asylum seekers during the resettlement process. A PRISMA-compliant scoping review based on Arskey and O'Malley's (2006) five steps was used. Four databases, Scopus, Embase, Ebsco, and ScienceDirect were searched for peer-reviewed articles published in English from 2000-2021. Studies were included if they reported on interventions, outcomes or the training received by adult peers to support refugees and asylum seekers during the resettlement process. Of an initial 632 journal articles retrieved, 14 met the inclusion criteria for this review. Most included studies were conducted in Western high-income countries, with the exception of one. Studies were heterogeneous in terms of the nationalities of peers and those receiving peer interventions; the outcomes reported on; the content of interventions, and the methodologies used. Findings suggest that peer interventions seem to be effective in addressing many of the challenges faced by refugees and asylum seekers. Community integration, acculturation and psychological distress are some of the key benefits. When such interventions are co-produced in participatory research involving refugees, asylum seekers and the civil society organisations that support this population, they are naturally culturally responsive and can therefore address issues relative to different ethnic needs during the resettlement process. This is the first scoping review to be conducted in this area and adds to what is a very limited body of research. Refugee, Asylum seeker, resettlement, scoping review

Exploration of the Independent Housing Experience of People with Mental Illness in a Community

Purpose: This study aims to explore the independent housing experiences of people with mental illness who receive supported independent housing services provided by the public sector.Methods: Data were collected through face-to-face interviews using semi-structured interviews. Twelve participants, who had been living independently in the community for around 11 months, were included. A qualitative descriptive method and a content analysis method were applied.Results: Independent housing experiences of people with mental illness were classified into the following four domains: house effect, growth, challenges and limitations, relationships, and support. Eleven categories included the starting point of life, environmental & psychological comfort, inspire independence and confidence, recognition of goals and responsibilities, positive self-awareness, psychological difficulties, immaturity of daily coping, unstable self-protection, relationship improvement, and importance of support resources.Conclusion: For successful community integration of mentally disabled people, continuous legal institutional preparation for stable housing, government active interest, and flexible financial support are needed. In addition to housing support, a recovery-based independent housing case management model needs to be developed for successful maintenance of independent living. We also suggest a study on the effectiveness of independent housing to determine evidence for making a policy.

Maximising Abilities, Negotiating and Generating Exercise options (MANAGE) in people with multiple sclerosis: A feasibility randomised controlled trial

Objective To investigate the feasibility and preliminary efficacy of a group self-management exercise and education program in people with multiple sclerosis. Design Feasibility randomised controlled trial. Setting Outpatient rehabilitation facility. Subjects Twenty-three adults (age 48.6 (11.7) years) recruited from a Multiple Sclerosis Clinic register. Interventions The intervention group undertook a 12-week group program incorporating behaviour change education, exercise and community integration. This was compared with a waitlist control group. Main measures Feasibility was measured by recruitment, adherence and safety. Efficacy outcomes included measures of physical function (6-metre and 6-min walk, Functional Reach) and self-report questionnaires (fatigue, quality of life, exercise benefits and barriers) at baseline, 6, 12 and 24 weeks. Results Of 74 individuals identified through the register, 48 (65%) were contacted and deemed eligible, and 23 (48%) agreed to participate. There was high adherence for attendance at education (57 of 72, 79%) and exercise (135 of 174, 78%) sessions. No adverse safety events occurred within the intervention sessions. Missed attendances at assessment sessions was high (5 to 8 participants missed at each time point) predominately due to health issues. The intervention group demonstrated positive changes in walking endurance, Functional Reach and fatigue, whereas the control had some reductions in walking speed and more perceived exercise barriers. Conclusions The MANAGE program appears feasible and safe for people with mild-to-moderate multiple sclerosis, with high adherence to exercise and education sessions. Future trials should consider strategies such as flexible scheduling or alternative methods of data collection to improve follow-up assessment attendance.

South African physiotherapists’ perspectives on the competencies needed to work in special schools for learners with special needs

Background: Investigation into, and description of competencies in the various sectors in which the physiotherapy profession is practised, contribute to the standardisation of practice, professional education, and guides research and administration, and is necessary in South Africa.Objective: To identify the competencies implemented by physiotherapists working in an educational setting for learners with special needs and to determine physiotherapists’ opinions on the identified competencies.Methods: A sequential mixed method research design was implemented to explore the competencies that physiotherapists implement during their intervention for children with special needs through focus group discussions (FGDs). A questionnaire based on the statements that emerged from the thematic analysis of the transcribed FGDs, and validated, was implemented in a cross-sectional survey amongst all physiotherapists employed in special schools. SPSS version 24 was used for the analysis of closed responses and thematic analysis was done on open-ended responses (n = 22).Results: The respondents’ knowledge and skills regarding physiotherapy theories and implementation ranged from ‘good’ to ‘very good’. However, integration of the therapeutic knowledge and skills in different aspects of the special educational environment, and community integration, were rated ‘poor’ to ‘fair’. Support of physiotherapists to implement policies and procedures, and to attend continuing professional development, ranged from ‘fair’ to ‘poor’.Conclusion: Lack of knowledge in educational policies and procedures in classroom strategies negatively influence the integration of therapeutic strategies in the special educational environment.Clinical implications: The contribution of our study to learners with special needs in schools was outlined.