Using an ideal types approach to tailor an intervention focused on reducing sedentary behaviour after stroke

Sedentary behaviour (SB) is defined as any waking behaviour characterised by low energy expenditure (≤1.5 Metabolic Equivalent of Task (METs)) while in a sitting, lying or reclining posture.

Research shows that stroke survivors spend long periods of time engaging in sedentary behaviour, even when they have made a good functional recovery. This can have negative impacts on their health and social activities.

The proposed work is an extension to the NIHR funded programme grant RECREATE, in which the Get Set Go intervention is currently being trialed and evaluated in 15 NHS stroke services. Get Set Go was developed using a co-production approach, guided by the Behaviour Change Wheel.

It focuses on training inpatient and community staff to support and encourage stroke survivors to stand and move more in everyday stroke care.

It also focuses on encouraging stroke survivors to monitor their standing and moving, with assistance where appropriate. The RECREATE process evaluation, underpinned by Medical Research Council guidance was conducted in six stroke services.

Feedback from staff and patients in the process evaluation interviews suggested that as currently delivered Get Set Go works well with certain types of stroke survivors; thus reducing the amount of people who could benefit from the intervention. Accordingly, Get Set Go needs refining in a way that benefits more stroke survivors.

An ideal-type analysis provides a rigorous way of achieving this. We aim to establish how we can refine 'Get Set Go' for different types of stroke survivors. The proposed research will be undertaken in 12 months.

Firstly, we will conduct a secondary analysis of the patient interview data using ideal-type analysis to produce types of stroke survivors in relation to their behaviours, traits or other factors that shape whether they engage in standing and moving interventions like 'Get Set Go.' Public Patient Involvement and Engagement (PPIE) will be integral to the work and includes: a core group of stroke survivors and carers, a staff group (from NHS and other organisations) and additional outreach work to draw upon diverse experiences.

Two meetings with each of the groups, plus outreach work will contribute to producing types of stroke survivors.

Next, we will establish how Get Set Go can be tailored to fit with what is meaningful to different types of stroke survivors (with input from one more meeting with each of the core group and staff group plus outreach).

Finally, with further input from the core group and staff group (one meeting each) and outreach work, we will produce recommendations for how 'Get Set Go' and other interventions aimed at reducing sedentary behaviour can be tailored to maximise positive health and social outcomes.

This novel approach will build on the RECREATE findings to understand how best to tailor interventions aimed at reducing sedentary behaviour. It will enhance our current engagement with stroke survivors, carers and staff.

Findings will be written in a final report, published in appropriate journals, and a further funding application will be developed. We will use creative ways of disseminating the findings widely.