Real world implementation of a group-based memory rehabilitation program into stroke services: A knowledge translation evaluation

Background: Support for memory difficulties remains a significant unmet need for survivors of stroke. Memory skills group training of compensatory strategies can be effective for improving everyday memory function. However, access to these services remains limited. Objectives: We aimed to evaluate the fidelity, acceptability, and effectiveness of implementing an evidence-based memory group in real-world clinical settings, to establish a potentially scalable implementation model. Methods: The program was facilitated at one acute and one community-based rehabilitation health service. Three clinical neuropsychologists received comprehensive training in facilitating the program. Implementation followed the Knowledge to Action framework, and implementation outcome measures included fidelity monitoring of adherence and competence, as well as clinician and participant reports of acceptability. The clinical effectiveness outcome was attainment of memory-specific goals using Goal Attainment Scaling at post-intervention and six-week follow-up. Results: The training process resulted in full adherence to the program content and demonstration of all essential clinical competencies. The program was acceptable and enjoyable for the clinicians and participants (n= 19, 63% male, 73% ischemic stroke). Participants demonstrated high levels of goal attainment (>80% at follow-up), comparable in magnitude to previous controlled trials. Conclusions: The stroke memory skills program has the potential to be implemented successfully in real-world clinical settings using the Knowledge to Action framework, incorporating comprehensive clinician training.