WeWalk: walking with a buddy after stroke. A pilot study evaluating feasibility and acceptability of a person-centred dyadic behaviour change intervention

Jacqui H. Morris (Lead / Corresponding author), Linda Irvine, Tricia Tooman, Stephan U. Dombrowski, Brendan McCormack, Frederike Van Wijck, Maggie Lawrence

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Abstract

Background: Evidence for benefits of physical activity after stroke is unequivocal. However, many people with stroke are inactive, spending >80% of waking hours sedentary even when they have physical capacity for activity, indicating barriers to physical activity participation that are not physical. WeWalk is a 12-week person-centred dyadic behaviour change intervention in which a person with stroke (PWS) and a walking buddy form a dyad to work together to support the PWS to increase their physical activity by walking outdoors. This pilot study examined feasibility of recruiting dyads and explored their perceptions of acceptability and experiences using WeWalk to identify required refinements before progression to a clinical trial.

Methods
: Design: A single-arm observational pilot study with qualitative evaluation. Intervention: WeWalk involved facilitated face-to-face and telephone sessions with a researcher who was also a behaviour change practitioner, supported by intervention handbooks and diaries, in which dyads agreed walking goals and plans, monitored progress, and developed strategies for maintaining walking. Evaluation: Descriptive data on recruitment and retention were collected. Interview data were collected through semi-structured interviews and analysed using thematic analysis, guided by a theoretical framework of acceptability

Results: We recruited 21 dyads comprising community dwelling PWS and their walking buddies. Ten dyads fully completed WeWalk before government-imposed COVID-19 lockdown. Despite lockdown, 18 dyads completed exit interviews. We identified three themes: acceptability evolves with experience, mutuality, and person-centred adaptability. As dyads recognised how WeWalk components supported walking, perceptions of acceptability grew. Effort receded as goals and enjoyment of walking together were realised. The dyadic structure provided accountability, and participants’ confidence developed as they experienced physical and psychological benefits of walking. WeWalk worked best when dyads exhibited relational connectivity and mutuality in setting and achieving goals. Tailoring intervention components to individual circumstances and values supported dyads in participation and achieving meaningful goals.

Conclusion: Recruiting dyads was feasible and most engaged with WeWalk. Participants viewed the dyadic structure and intervention components as acceptable for promoting outdoor walking and valued the personally tailored nature of WeWalk. Developing buddy support skills and community delivery pathways are required refinements. ISCTRN number: 34488928
Original languageEnglish
Article number10
Number of pages15
JournalPilot and Feasibility Studies
Volume9
DOIs
Publication statusPublished - 13 Jan 2023

Keywords

  • Behaviour change
  • Feasibility
  • Intervention development
  • Physical activity
  • Stroke
  • Walking

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