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Amaefule E, Rodriguez-Yu V, Uphold CR. Two Unique Educational Programs for Improving the Knowledge and Skills of Veterans with Stroke and their Caregivers. Poster session presented at: Southern New England Rehabilitation Center Annual Rehabilitation Conference for Professionals; 2012 Jun 20; Atlanta, GA.
Significance: In the United States, stroke is the leading cause of adult disability. Stroke affects roughly 800,000 people per year and approximately 6.2 million people are living with the consequences of stroke. Because strokes occur suddenly, survivors and caregivers need extensive education to prevent second strokes and to manage the aftermath of stroke. Within the VA, education is considered an important tool in disease prevention and management. Objectives: The objective is to illustrate how two different stroke-education programs can be implemented to improve VA healthcare. Program #1: In-Person Educational Series: To provide information to improve prevention and management of strokes through a series of interactive seminars for stroke survivors and their caregivers Program #2: Web-based Education Project: To empower family caregivers with information to improve their knowledge and skills in managing their own problems and those of their Veterans through the RESCUE stroke caregiver website. Methods: Program #1: In-Person Educational Series at VA Puget Sound Health Care Systems, Seattle WA. In 2009, we gathered the names of all stroke Veterans from VHA database in our VISN. We sent letters to those Veterans describing our goals of an education series and requested their input on all topics of interest. We enclosed self-addressed stamped envelopes for return questionnaires. After several meetings of the Stroke Team deliberating on topics and responses from Veterans, the Stroke Education Series was created. Our interdisciplinary stroke team has developed an educational series to provide information on understanding, preventing and managing stroke. Some topics include: understanding stroke, functional recovery, contracture management, communication and cognition, adjustment and psychosocial issues. Our education series meet twice a month on first and third Tuesdays of the month. They are usually lectures followed by interactive discussions with social support interventions. Our interdisciplinary stroke team provides comprehensive education to all stroke survivors to maximize each individual patient's function including those who have difficulty resuming their pre-stroke activities. Program #2: Web-based Education Project at the VA North Florida/South Georgia Rehabilitation Outcomes Research Center We used evidenced-based "best practices" to create a low-literate, senior-friendly VA website that is written in both English and Spanish languages. The website (http:www.rorc.resarch.va.gov/rescue) is called RESCUE, which stands for Resources and Education for Stroke Caregivers' Understanding and Empowerment) website. We pretested the website in multiple ways: a) focus groups with providers (total n = 32), b) in-person interviews with culturally-diverse family caregivers (n = 45), and c) expert panel of clinicians (n = 11). The website consists of a library of 45 factsheets, a problem-solving learning module, self-help tools, resource list, patient education newsletters, and a glossary with phonetic spellings. Evaluation: Program #1: In-Person Educational Series Since the conception of our stroke education series, there have been excellent reviews (formal and informal) from patients, family members and caregivers. Usually after each session, evaluation forms are passed out to all attendees. The Stroke Team members also dialogue with attendees to get feedback on topics. So far, our Stroke Education Series has been adjusted based on feedback from patients. We recently changed the time of day and day of the week based on majority patients' availability. Some topics e.g. sex/sexuality post stroke, recreation/community and transportation, and exercises/stroke prevention have also been added to meet the demand. Program #2: Web-based Education Project On-line surveys indicated that healthcare providers view the website as a credible tool for educating caregivers and stated that the website is informative, comprehensive, and up-to-date. A cognitive "think aloud" usability study with caregivers (n = 7) and providers (n = 8) revealed that the website was attractive, easy-to-navigate, and understandable. Webtrends analytics found that there were over 6800 visits to the website and that website usage has increased significantly since its launch. Conclusion: Education remains a vital aspect of care and management of debilitating illnesses especially stroke. Different educational methods are effective in improved stroke-related outcomes. The in-person education series provides social support and a forum for survivors and caregivers to learn from each other. Alternatively, the RESCUE website provides a breadth of stroke-related information and reaches a large number of persons. *Acknowledgement to the VA Puget Sound Health Care Systems *Stroke Team*, Seattle WA; and the RESCUE team at the North Florida/South Georgia Rehabilitation Outcomes Research Center
