Trial reportBMC medical research methodology2016
Implementing a complex rehabilitation intervention in a stroke trial: a qualitative process evaluation of AVERT.
Trial report in BMC medical research methodology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 5 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Optimising adherence to inpatient rehabilitation trial protocols: A mixed-methods systematic review.Clinical trials (London, England) · 2025Pooled it
- Stroke Rehabilitation Clinical Practice Guidelines in Low- and Middle-Income Countries: A Systematic Review of Quality and Unique Features.Cerebrovascular diseases (Basel, Switzerland) · 2025Pooled it
- Factors affecting the delivery of complex rehabilitation interventions in research with neurologically impaired adults: a systematic review.Systematic reviews · 2020Pooled it
- Can in-hospital or post discharge caregiver involvement increase functional performance of older patients? A systematic review.BMC geriatrics · 2020Pooled it
- Qualitative evaluation in nursing interventions-A review of the literature.Nursing open · 2020Pooled it
- Trial
- Process evaluation of an implementation trial to improve the triage, treatment and transfer of stroke patients in emergency departments (TImplementation science : IS · 2020Trial
- Implementation of a billable transitional care model for stroke patients: the COMPASS study.BMC health services research · 2019Trial
- Trial
- Healthcare providers' experience of delivering a heart rate variability feedback intervention to individuals living with spinal cord injury to inform implementation into usual care.BMC health services research · 2026Article
- Co-designed neck exercise (EPIC-Neck) vs usual exercise care for people with chronic non-specific neck pain: protocol for a randomised feasibility study with process evaluation.Pilot and feasibility studies · 2025Article
- Feasibility, Fidelity and Acceptability of a Person-Centred Care Transition Support Intervention for Stroke Survivors: A Non-Randomised Controlled Study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Adherence to behavioural intervention in RCT study by the women experiencing domestic violence and attending ANC in a public hospital in India-an analysis.Dialogues in health · 2023Article
- Early and Intensive Motor Training for people with spinal cord injuries (the SCI-MT Trial): protocol of the process evaluation.BMJ open · 2023Article
- Clinical and systems of care factors contributing to individual patient decision-making for early mobilization post-stroke.Frontiers in stroke · 2023Article
- Functional standing frame programme early after severe sub-acute stroke (SPIRES): a randomised controlled feasibility trial.Pilot and feasibility studies · 2022Article
- Article
- Mechanisms of impact and contextual aspects of a dementia special care unit in long-term care: a process evaluation.BMC geriatrics · 2021Article
- Feasibility of an integrated multidisciplinary geriatric rehabilitation programme for older stroke patients: a process evaluation.BMC neurology · 2020Article
- Contamination in complex healthcare trials: the falls in care homes (FinCH) study experience.BMC medical research methodology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe implementation of multidisciplinary stroke rehabilitation interventions is challenging, even when the intervention is evidence-based. Very little is known about the implementation of complex interventions in rehabilitation clinical trials. The aim of study was to better understand how the implementation of a rehabilitation intervention in a clinical trial within acute stroke units is experienced by the staff involved. This qualitative process evaluation was part of a large Phase III stroke rehabilitation trial (AVERT).
methodsA descriptive qualitative approach was used. We purposively sampled 53 allied health and nursing staff from 19 acute stroke units in Australia, New Zealand and Scotland. Semi-structured interviews were conducted by phone, voice-internet, or face to face. Digitally recorded interviews were transcribed and analysed by two researchers using rigorous thematic analysis.
resultsOur analysis uncovered ten important themes that provide insight into the challenges of implementing complex new rehabilitation practices within complex care settings, plus factors and strategies that assisted implementation. Themes were grouped into three main categories: staff experience of implementing the trial intervention, barriers to implementation, and overcoming the barriers. Participation in the trial was challenging but had personal rewards and improved teamwork at some sites. Over the years that the trial ran some staff perceived a change in usual care. Barriers to trial implementation at some sites included poor teamwork, inadequate staffing, various organisational barriers, staff attitudes and beliefs, and patient-related barriers. Participants described successful implementation strategies that were built on interdisciplinary teamwork, education and strong leadership to 'get staff on board', and developing different ways of working.
conclusionsThe AVERT stroke rehabilitation trial required commitment to deliver an intervention that needed strong collaboration between nurses and physiotherapists and was different to current care models. This qualitative process evaluation contributes unique insights into factors that may be critical to successful trials teams, and as AVERT was a pragmatic trial, success factors to delivering complex intervention in clinical practice.
trial registrationAVERT registered with Australian New Zealand Clinical Trials Registry ACTRN12606000185561 .
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.