Table 2.
Description of assessments
| Assessment | Description | Time Completed |
|---|---|---|
| Screening | ||
| Short blessed test (SBT) | The SBT assesses one’s cognitive ability using 6 items. Each item has a weighted score based on the number of errors made. The total score can range from 0 to 28. The cutoff score for screening was 9 and higher which indicates that the person has cognitive impairment26 | Screening before randomization |
| Boston diagnostic aphasia exam (BDAE) | The BDAE was used to screen aphasia. Examinees are asked to follow three commands and get one point for each correct action. The total score ranges from 0 to 10. The cutoff score was 8 and lower27 | Screening before randomization |
| Boston naming test (BNT) | The 15-item short form BNT was used to screen aphasia. Testers are asked to name 15 pictures on cards and get one point for each correctly named object. The total score ranges from 0 to 15. The cutoff score was 9 and lower28 | Screening before randomization |
| Primary outcome measures | ||
| Chronic disease self-efficacy scale (CDSES) | This scale measures an individual’s confidence in performing specific tasks or behaviors to manage medical conditions. The scale consists of 20 questions and is rated on a Likert scale of 1–10 with higher scores indicating greater self-efficacy. The scale has shown high internal consistency coefficients (ranging from 0.77 to 0.92) and test–retest coefficients (from 0.72 to 0. 89)25 | Baseline, post-intervention, long-term follow-up interviews |
| Participation strategies self-efficacy scale (PS-SES) | The PS-SES measures self-efficacy in using strategies that help participation in home, community, work, and social activities. The scale consists of 35 questions and is rated on a Likert scale of 1–10 with higher scores indicating greater self-efficacy. The measure has strong internal consistency24 | Baseline, post-intervention, long-term follow-up interviews |
| Secondary outcome measures | ||
| Community participation indicators (CPI) | The CPI includes objective ratings of participation across major life areas (i.e., frequency of engagement) with subjective ratings of participation values (i.e., importance and satisfaction) and enfranchisement (e.g., inclusion, choice, opportunity, social capital membership). Findings from the factor analyses and Item Response Theory (IRT) analysis support validity of the instrument29 | Baseline, post-intervention, long-term follow-up interviews |
| Reintegration to normal living (RNL) | The RNL covers participation in areas such as recreational and social participation, community mobility, family roles, and other relationships.30 It consists of 11 items with a Likert scale of 0–10. Higher total score indicates stronger integration into the community. RNL has a strong inter-rater reliability (r>0.91). Construct validity was examined comparing RNL with Barthel Index (r = 0.42), Short Form 36 (r = 0.74), and Frenchay Activities Index (r=0.69). | Baseline, post-intervention, long-term follow-up interviews |
| Activity card sort (ACS) | The ACS assesses a person’s engagement in activities. This measure can show how many activities a person is involved in. Using 89 activity cards with pictures, participants indicate their current involvement using following response options: “didn’t do before stroke,” “do now,” “do less,” “given up,” and “started after stroke” Percent of retained activities are calculated. The measure has excellent test–retest reliability and excellent concurrent validity with community dwelling adults31 | Baseline, post-intervention, long-term follow-up interviews |
| WHO quality of life scale (WHOQOL-BREF) | The WHOQOL-BREF comprises 26 items measuring physical health, psychological health, social relationships, and environment. Cronbach’s alpha ranged from 0.66 to 0.84, demonstrating good internal consistency32 | Baseline, post-intervention, long-term follow-up interviews |
| Stroke impact scale (SIS) | The SIS has 60 items that assess the impact of stroke using a 5-point difficulty Likert scale. The SIS has seven subcategories: strength, function, mobility, emotion, communication, cognition, and participation. The measure has an adequate to excellent internal consistency with chronic stroke survivors33 | Baseline, post-intervention, long-term follow-up interviews |