Everyday life is Rehabilitation (ELiR): a home-based behavior change intervention for people with stroke and diabetes–user acceptability and appropriateness of the ELiR instrument

Purpose: Stroke and type 2 diabetes mellitus (DM) pose significant health challenges, necessitating innovative and holistic rehabilitation strategies. Promotion of physical activity (PA) and reduction of sedentary behaviour (SB) are essential for managing both conditions. The aim was to evaluate the user-acceptability and appropriateness of the ‘Everyday Life is Rehabilitation’ (ELiR) instrument, designed to address SB and PA. Methods: Subsequently to participating in the 12-week ELiR intervention, participants evaluated the ELiR instrument. Participant evaluations were conducted through cognitive interviews (CI) in community rehabilitation and in participants’ homes. The main outcome measures included feedback on user-acceptability and appropriateness of the ELiR instrument and participant agreement with evaluation statements. Results: Fourteen stroke survivors with DM completed the evaluations. CI feedback highlighted the need for adjustments, particularly a concrete tool for fatigue management and motivational support. Although minor changes were suggested, the ELiR was found to be valuable and useful overall. Participant feedback informed subsequent refinements to optimise the instrument for future clinical use. Conclusion: The modified and updated ELiR instrument is a promising cross-sectoral tool for improving PA and reducing SB in stroke survivors with DM. The adjustments, especially regarding fatigue management, were necessary to optimise its effectiveness in clinical practice.