Evidence map›Paper›PMID 35101133›Full record

ArticlePilot and feasibility studies2022

Feasibility of deploying peer coaches to mentor frontline home health aides and promote mobility among individuals recovering from a stroke: pilot test of a randomized controlled trial.

Penny H Feldman, Margaret V McDonald, Nicole Onorato, Joel Stein, Olajide Williams

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Pilot and feasibility studies, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04840407 (Assessing a Stroke Home Health Aide Recovery Program), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT04840407 nacompletednot on this map

Assessing a Stroke Home Health Aide Recovery Program (SHARP) as a Potential High Impact Strategy for Improving Functional Mobility After Stroke

TypeinterventionalSponsorVisiting Nurse Service of New YorkRan2018 to 2019Enrolled60ConditionsStrokeArmsSHARP coach intervention
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Home-Based Gait Interventions for Adults with Stroke: A Scoping Review.Archives of rehabilitation research and clinical translation · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Penny H FeldmanCenter for Home Care Policy & Research, Visiting Nurse Service of New York, 220 East 42nd Street, New York, NY, 10017, USA.
Margaret V McDonaldCenter for Home Care Policy & Research, Visiting Nurse Service of New York, 220 East 42nd Street, New York, NY, 10017, USA. Margaret.mcdonald@vnsny.org.ORCID http://orcid.org/0000-0003-1045-0956
Nicole OnoratoCenter for Home Care Policy & Research, Visiting Nurse Service of New York, 220 East 42nd Street, New York, NY, 10017, USA.
Joel SteinDepartment of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, Department of Rehabilitation Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, 180 Ft. Washington Ave., Harkness Pavilion Room 1-165, New York, NY, 10032, USA.
Olajide WilliamsDepartment of Neurology, Columbia University, 710 West 168th Street, New York, NY, 10032, USA.
VNS Health · USColumbia University · USNewYork–Presbyterian Hospital · US

Funding

Assessing a Stroke Homehealth Aide Recovery Program (SHARP) as a Potential High Impact Strategy for Improving in Functional Mobility after StrokeR21HD089013 · NICHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI WILLIAMS, OLAJIDE · 2017 to 2018
$444k
NICHD NIH HHS R21 HD089013
6 · The paper itself

Abstract

backgroundEach year, approximately 100,000 individuals receive home health services after a stroke. Evidence has shown the benefits of home-based stroke rehabilitation, but little is known about resource-efficient ways to enhance its effectiveness, nor has anyone explored the value of leveraging low-cost home health aides (HHAs) to reinforce repetitive task training, a key component of home-based rehabilitation. We developed and piloted a Stroke Homehealth Aide Recovery Program (SHARP) that deployed specially trained HHAs as "peer coaches" to mentor frontline aides and help individuals recovering from stroke increase their mobility through greater adherence to repetitive exercise regimens. We assessed the feasibility of SHARP and its readiness for a full-scale randomized controlled trial (RCT). Specifically, we examined (1) the practicability of recruitment and randomization procedures, (2) program acceptability, (3) intervention fidelity, and (4) the performance of outcome measures.

methodsThis was a feasibility study including a pilot RCT. Target enrollment was 60 individuals receiving post-stroke home health services, who were randomized to SHARP + usual home care or usual care only. The protocol specified a 30-day intervention with four planned in-home coach visits, including one joint coach/physical therapist visit. The primary participant outcome was 60-day change in mobility, using the performance-based Timed Up and Go and 4-Meter Walk Gait Speed tests. Interviews with participants, coaches, physical therapists, and frontline aides provided acceptability data. Enrollment figures, visit tracking reports, and audio recordings provided intervention fidelity data. Mixed methods included thematic analysis of qualitative data and quantitative analysis of structured data to examine the intervention feasibility and performance of outcome measures.

resultsAchieving the 60-participant enrollment target required modifying participant eligibility criteria to accommodate a decline in the receipt of HHA services among individuals receiving home care after a stroke. This modification entailed intervention redesign. Acceptability was high among coaches and participants but lower among therapists and frontline aides. Intervention fidelity was mixed: 87% of intervention participants received all four planned coach visits; however, no joint coach/therapist visits occurred. Sixty-day follow-up retention was 78%. However, baseline and follow-up performance-based primary outcome mobility assessments could be completed for only 55% of participants.

conclusionsThe trial was not feasible in its current form. Before progressing to a definitive trial, significant program redesign would be required to address issues affecting enrollment, coach/HHA/therapist coordination, and implementation of performance-based outcome measures.

trial registrationClinicalTrials.gov, NCT04840407 . Retrospectively registered on 9 April 2021.

Indexed as

Home health aidesIntervention feasibilityIntervention fidelityPeer coachesPilot randomized controlled trialPost-stroke mobilityStroke rehabilitation

Identifiers

PMID35101133
PMCPMC8801561
OpenAlexW4210310191

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.