Is a novel digital system for arm and hand rehabilitation suitable for stroke survivors? A qualitative process evaluation of OnTrack

Objectives and design National guidelines emphasise the need to enhance arm hand recovery poststroke. OnTrack is a 12-week package aiming address this need. Feasibility was evaluated in single-arm feasibility study (reported separately). This paper presents findings from nested process evaluation. The objectives were explore users’ experiences of fidelity delivery, order inform definitive trial effectiveness future delivery. Setting Participants interviewed range settings hospital, home or via telephone, at end their intervention cycle. Session observations for selection coaching sessions carried out person remotely, post-COVID-19. Eleven participants who completed following stroke interviewed. Seven observed. Intervention evaluation part larger OnTrack, which involves setting movement targets monitoring activity using tracker on wrist, motivational messaging Smartphone self-management coaching. Preliminary analysis data collected conducted with public patient involvement group formed survivors. informed changes Results reported finding programme beneficial, role seen as particularly important. found tracking motivating, but some noted discrepancies between tracked what they considered useful activity. Motivational messages sometimes irritating. Most felt ready sustain own practice programme. Conclusions supported initial theoretical assumptions that would enable through use remote monitoring. There strong emphasis mechanism impact supporting technological intervention. These will next stages delivery trial. Trial registration number NCT03944486 .