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1. Citation: McEwen, S. E., Donald, M., Dawson, D., Egan, M. Y., Hunt, A., Quant, S., Runions, S., & Linkewich, E. (2015). A multi-faceted knowledge translation approach to support persons with stroke and cognitive impairment: evaluation protocol. Implementation Science, 10, 157. doi:10.1186/s13012-015-0346-6
Title: A multi-faceted knowledge translation approach to support persons with stroke and cognitive impairment: evaluation protocol
Author(s): McEwen, S. E.
Donald, M.
Dawson, D.
Egan, M. Y.
Hung, A.
Quant, S.
Runions, S.
Linkewich, E.
Year: 2015
Journal/Publication: Implementation Science

Study protocol:


Patients with cognitive impairments following a stroke are often denied access to inpatient rehabilitation. The few patients with cognitive impairment admitted to rehabilitation generally receive services based on outdated impairment-reduction models, rather than recommended function-based approaches. Both reduced access to rehabilitation and the knowledge-to-practice gap stem from a reported lack of skills and knowledge regarding cognitive rehabilitation on the part of inpatient rehabilitation team members. To address these issues, a multi-faceted knowledge translation (KT) initiative will be implemented and evaluated. It will be targeted specifically at the inter-professional application of the cognitive orientation to daily occupational performance (CO-OP). CO-OP training combined with KT support is called CO-OP KT. The long-term objective of CO-OP KT is to optimize functional outcomes for individuals with stroke and cognitive impairments. Three research questions are posed:

1. Is the implementation of CO-OP KT associated with a change in the proportion of patients with cognitive impairment following a stroke accepted to inpatient rehabilitation?

2. Is the implementation of CO-OP KT associated with a change in rehabilitation clinicians’ practice, knowledge, and self-efficacy related to implementing the CO-OP approach, immediately following and 1 year later?

3. Is CO-OP KT associated with changes in activity, participation, and self-efficacy to perform daily activities in patients with cognitive impairment following stroke at discharge from inpatient rehabilitation and at 1-, 3-, and 6-month follow-ups?


Three interrelated studies will be conducted. Study 1 will be a quasi-experimental, interrupted time series design measuring monthly summaries of stroke unit level data. Study 2, which relates to changes in health care professional practice and self-efficacy, will be a single group pre-post evaluation design incorporating chart audits and a self-report survey. Study 3 will assess patient functional outcomes using a non-randomized design with historical controls. Assessments will occur during admission and discharge from rehabilitation and at 1, 3, and 6 months following discharge from rehabilitation.


This project will advance knowledge about the degree to which the implementation of a supported KT initiative can sustainably change health system, knowledge, and patient outcomes.

Cognitive orientation to daily occupational performance; Stroke; Cognitive impairment; Rehabilitation; Knowledge translation; Interrupted time series; Protocol

Type of Item: Evaluation Instrument
Type of KT Strategy: Facilitation
Targeted Messages
Web-based Training
Target Group: Healthcare Professional
Evidence Level: 4
Record Updated:2015-11-05