ArticleFrontiers in stroke2026
Implementing and sustaining 6-month post-stroke reviews: a complexity-informed, context-sensitive programme theory for clinical practice.
Article in Frontiers in stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Introduction: Stroke is a leading cause of long-term disability. Six-month post-stroke reviews are recommended in multiple guidelines to identify the ongoing needs of stroke survivors and facilitate follow-up care. However, guidance on how to deliver these reviews optimally is limited. This study developed a complexity-informed, context-sensitive programme theory for the 6-month post-stroke review, clarifying its core components and producing actionable recommendations to guide implementation and sustainability across diverse contexts. Methods: The programme theory was developed from empirically derived patterns identified in a multiple case study in England, based on data collected from interest-holder interviews, observations, and documentary analysis. Context-mechanism-outcome configurations were developed heuristically through a pragmatic approach. These informed the structure and content of the programme theory and logic model. A complexity theory lens facilitated identification of multi-level system dynamics, supporting applicability across diverse contexts. The model was iteratively refined by the research team and adjusted following validation feedback from international stroke rehabilitation experts and 6-month post-stroke review interest-holders. Results: Fourteen context-mechanism-outcome configurations informed 13 core components nested within four core domains of the 6-month review: Conclusions: This study presents the first complexity-informed, context-sensitive programme theory for the 6-month post-stroke review. By translating empirically driven theory into actionable recommendations, it supports clinicians and service planners in delivering person-centered, contextually adaptable follow-up care. It also provides a foundation for future evaluation of post-stroke services internationally, enabling systematic testing of its hypothesized outcomes and adaptation across diverse healthcare settings.
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