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Trial registered on ANZCTR
Registration number
ACTRN12616000799459
Ethics application status
Approved
Date submitted
13/06/2016
Date registered
20/06/2016
Date last updated
16/06/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Does a stroke self-management program for people with mild stroke discharged home improve recovery outcomes as compared to usual care?
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Scientific title
Mild Stroke: Enhancing and Guiding Transition Home
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Secondary ID [1]
287466
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Nil known
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Universal Trial Number (UTN)
U1111-1174-3557
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Trial acronym
MiStrEnGTH
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cerebrovascular Accident (Stroke)
296194
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Condition category
Condition code
Stroke
296469
296469
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0
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Ischaemic
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Stroke
296470
296470
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0
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Haemorrhagic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A stroke self-management program (SSMP) delivered using telehealth for individuals with mild stroke who are discharged home after acute stroke management only. Five telephone-based sessions of between 30 and 60 minutyes will be provided during the first 6 months after stroke. During these phone-based sessions the therapist will speak to both the person with stroke and the carer. The sessions will occur 1-, 4- and 8-weeks post hospital discharge, with the final 2 sessions scheduled based on the needs of the person with stroke within the first 6 month period. The SSMP program will be tailored to the individual needs of the person with stroke and their family. Each session will follow a pre-developed framework which includes the following:
1. Reflection: an opportunity to reflect on areas of change in their life since stroke including acknowledgement on progress and achievements.
2. Management: Identification of areas of life that have been impacted upon by the stroke through in-depth discussion followed by unmet needs from community or rehabilitation services.
3. Goal-planning: Information discussed in the reflection and management stages of the sessions will be used to guide to goal-planning. Goal planning will occur with both the person with stroke and their family as required. It will use a shared decision making process and / or motivational interviewing framework in order to develop the goals and then plan the actions required to achieve the goals.
4. Education: Educational needs related to stroke identified during the session will also be addressed through the therapist providing verbal information +/- directing the person to available resources (e.g. stroke support groups, Stroke Foundation websites).
At the conclusion of each session the therapist will send the person with stroke and family as required a copy of the developed goals and the action plans associated with them, as well as any written information or website links that might assist the person in achieving their goals or addressing educational needs. Email will be the preferred mode of delivering this information.
The SSMP will be provided in addition to usual care processes on an individual basis. The program will be delivered by an allied health professional with extensive experience in the management of people with stroke.
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Intervention code [1]
292842
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Rehabilitation
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Comparator / control treatment
Standard treatment will be provided which may include stroke education, discharge report to patient's general practitioner, follow-up stroke clinic appointment 1 to 3 months post-stroke, and referral to services as required.
Stroke Education will at a minimum involves provision of a hard copy booklet on hospital discharge known as "My Stroke Journey" which has been developed by the National Stroke Foundation, Australia. Modules within this package are:
1. About Stroke (including information about: What is a stroke? Types of stroke; How a stroke can affect you)
2. Reduce your risk
3. Rehabilitation and leaving hospital
4. Carer information
5. Further information (including information about where to get more help, websites, list of available fact sheets)
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Control group
Active
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Outcomes
Primary outcome [1]
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Assessment of Quality of Life 6D (AQoL-6D)
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Assessment method [1]
296097
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Timepoint [1]
296097
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Hospital discharge, 1-week post discharge, 3-months post-stroke, and 6-months post-stroke
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Primary outcome [2]
296098
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Depression Anxiety and Stress Scale-21 items (DASS-21)
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Assessment method [2]
296098
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Timepoint [2]
296098
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Hospital discharge, 1-week post discharge, 3-months post-stroke, and 6-months post stroke
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Secondary outcome [1]
317481
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Re-integration to Normal Living Index
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Assessment method [1]
317481
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Timepoint [1]
317481
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1-week post discharge, 3-months post-stroke and 6-months post stroke
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Secondary outcome [2]
317483
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Fatigue Scale for Motor and Cognitive Functions (FSMC)
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Assessment method [2]
317483
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Timepoint [2]
317483
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Hospital discharge, 1-week post discharge, 3-months post-stroke, and 6-months post-stroke
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Secondary outcome [3]
317485
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Confidence after Stroke Measure (CASM)
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Assessment method [3]
317485
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Timepoint [3]
317485
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Hospital discharge, 1-week post discharge, 3-months post-stroke, and 6-months post-stroke
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Secondary outcome [4]
317486
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Patient Competency Rating Scale (PCRS)
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Assessment method [4]
317486
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Timepoint [4]
317486
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Hospital discharge, 1-week post discharge, 3-months post-stroke, and 6-months post-stroke
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Secondary outcome [5]
317487
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Service Satisfaction Visual Analogue Scale
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Assessment method [5]
317487
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Timepoint [5]
317487
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Hospital discharge, 1-week post discharge, 3-months post-stroke, and 6-months post-stroke
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Secondary outcome [6]
317489
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Carer Strain Index (CSI)
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Assessment method [6]
317489
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Timepoint [6]
317489
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Hospital discharge, 1-week post discharge, 3-months post-stroke, and 6-months post-stroke
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Eligibility
Key inclusion criteria
Stroke participants
- admitted with a confirmed new onset mild stroke
- receive acute hospital management only
- discharge destination is home or a community environment
Carers of the stroke participant
- provide informal assistance / support to a participant in the stroke group
- assistance / support role will likely be ongoing during the course of the study
- over 18 years of age
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Stroke participants
- inadequate language or cognition to provide informed consent and / or complete outcome measures
- discharged to residential care facility or other healthcare facility
- existing comorbidites likely to limit participation in program (e.g. dementia or severe mental illness)
Carers of the stroke participants
- inadequate language or cognition to provide informed consent and / or complete outcome measures
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
19/01/2016
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Date of last participant enrolment
Anticipated
30/06/2017
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Actual
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Date of last data collection
Anticipated
22/12/2017
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Actual
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Sample size
Target
96
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
5962
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The Prince Charles Hospital - Chermside
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Recruitment hospital [2]
5963
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Royal Brisbane & Womens Hospital - Herston
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Recruitment postcode(s) [1]
13384
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4032 - Chermside
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Recruitment postcode(s) [2]
13385
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4029 - Royal Brisbane Hospital
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Funding & Sponsors
Funding source category [1]
293797
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Government body
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Name [1]
293797
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Allied Health Professionals Office Queensland
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Address [1]
293797
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Queensland Health Building
Butterfield Street, Herston Qld 4029
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Country [1]
293797
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Australia
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Funding source category [2]
293798
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Charities/Societies/Foundations
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Name [2]
293798
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National Stroke Foundation
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Address [2]
293798
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Level 7, 461 Bourke St
Melbourne, Vic 3000
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Country [2]
293798
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Australia
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Primary sponsor type
Hospital
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Name
The Prince Charles Hospital
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Address
627 Rode Rd, Chermside Qld 4032
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Country
Australia
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Secondary sponsor category [1]
292631
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Hospital
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Name [1]
292631
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Royal Brisbane and Women's Hospital
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Address [1]
292631
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Butterfield St, Herston, Qld 4029
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Country [1]
292631
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Australia
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Other collaborator category [1]
279034
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University
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Name [1]
279034
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The University of Queensland
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Address [1]
279034
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St Lucia Campus, St Lucia Qld 4072
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Country [1]
279034
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Australia
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Other collaborator category [2]
279035
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University
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Name [2]
279035
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Australian Catholic University
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Address [2]
279035
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McAuley Campus,
1100 Nudgee Road
Banyo Queensland 4014
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Country [2]
279035
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295231
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The Prince Charles Hospital Human Research and Ethics Committee
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Ethics committee address [1]
295231
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627 Rode Rd, Chermside Qld 4032
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Ethics committee country [1]
295231
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Australia
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Date submitted for ethics approval [1]
295231
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09/06/2015
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Approval date [1]
295231
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27/08/2015
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Ethics approval number [1]
295231
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HREC/15/QPCH/18
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Summary
Brief summary
Major issues impacting survivors of stroke & their carers are reduced quality of life & depression. The period of transition from hospital to home is a critical time for recovery for survivors of mild stroke; bridging hospital discharge to community integration. It has been identified that stroke survivors feel ill-prepared mentally and physically to return to their lives after discharge from hospital (Cott et al., 2007; Turner et al., 2009; Rittman, Boylstein, Hinojosa et al., 2007). A discharge care plan developed by the stroke team focusing on the needs & goals of the person with stroke facilitates the transition home inclusive of medical management, ongoing rehabilitation, and education around lifestyle modification. However, a recent clinical audit of the Australian facilities revealed that less than 50% of survivors of stroke discharged from acute care received this (National Stroke Foundation, 2014). Survivors of mild stroke, typically present with minimal impairments & are often discharged home without inpatient rehabilitation. Recent research highlights that the impact of stroke only becomes obvious on returning home when re-engaging in previous life roles (e.g. work, leisure). The overarching aim of this research is to determine the efficacy of a new allied healthled model of care for individuals with mild stroke discharged from acute care. The primary aim is to assess the efficacy of MiStrEnGTH as compared to usual care on quality of life (QoL) and client mood. A secondary aim is to assess the efficacy of MiStrEnGTH as compared to usual care on daily activity, community participation, carer mood and strain. It is hypothesized that clients and carers receiving MiStrEnGTH will have improved QoL, mood and community participation, with lower levels of carer strain as compared to usual care. A study design of a randomized controlled trial with intention-to-treat analysis will be used. All participants with acute mild stroke will be randomized to one of two intervention arms at discharge: 1) control 'standard care'; 2) intervention 'MiStrEnGTH'. Data collection from participants will occur at baseline (recruitment), and 1-, 3- and 6-months post-discharge from hospital.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
60306
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A/Prof Petrea Cornwell
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Address
60306
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Allied Health Research Collaborative
The Prince Charles Hospital
627 Rode Rd, Chermside Qld 4032
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Country
60306
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Australia
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Phone
60306
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+61 7 3139 6112
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Fax
60306
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N/a
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Email
60306
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[email protected]
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Contact person for public queries
Name
60307
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Petrea Cornwell
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Address
60307
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Allied Health Research Collaborative
The Prince Charles Hospital
627 Rode Rd, Chermside Qld 4032
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Country
60307
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Australia
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Phone
60307
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+61 7 3139 6112
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Fax
60307
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Email
60307
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[email protected]
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Contact person for scientific queries
Name
60308
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Petrea Cornwell
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Address
60308
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Allied Health Research Collaborative
The Prince Charles Hospital
627 Rode Rd, Chermside Qld 4032
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Country
60308
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Australia
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Phone
60308
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+61 7 3139 6112
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Fax
60308
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Email
60308
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF