My Therapy in rehabilitation: The process evaluation study protocol of a self-management program supported by health professionals

Statement of the Problem: Within strained healthcare systems, providing sufficient practice for rehabilitation patients can be difficult. The adult inpatient rehabilitation service standards recommend three hours per day of therapy and weekend therapy. However, there is an evidence-practice gap as many services provide on weekdays less than the recommended dosage of therapy and on the weekends less than half of the Australian rehabilitation services provide therapy. The challenges faced by rehabilitation therapists led to the development of My Therapy, which is a consumer driven, self-management program that increases the amount of practice that patients do during rehabilitation. It is tailored to individual needs, is recommended by a patient’s occupational therapist and physiotherapist, and can be practiced within business hours, in the evenings or over the weekend. The initial benefits of My Therapy were established during pilot research showing that My Therapy achieved around 100-minutes of extra weekly practice alongside usual care and compared to usual care, improved functional outcomes. Methodology & Theoretical Orientation: This is a multi-site clinical trial funded by a NHMRC Partnership grant, and includes a clinical evaluation, economic evaluation, and a process evaluation. Process evaluations are an essential part of testing complex program implementation. The aim of the process evaluation is to firstly, assess implementation of the My Therapy intervention, considering fidelity, quality of implementation acceptability and adoption; and secondly, to identify contextual factors associated with variations in outcomes. Findings: Recruitment is currently at the halfway point and sitting at around 2000 participants. Conclusion & Significance: If this trial demonstrates that My Therapy is both clinically effective and cost-effective there are long-term implications, including sustained implementation at the participating health services, scaling to other health networks, as well as having the potential to influence rehabilitation models and relevant policy to improve rehabilitation outcomes