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Exploring barriers and facilitators to healthcare professional implementation of a stroke physical activity behaviour change intervention to inform targeted strategies: a qualitative study

Lookup NU author(s): Sarah Moore, Dr Sebastian Potthoff

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Purpose: Physical activity improves outcomes after stroke, but barriers exist to healthcare professionals promoting physical activity in this population. This study explored barriers and facilitators to healthcare professional implementation of a stroke physical activity behaviour change intervention, Physical Activity Routines After Stroke (PARAS), to inform targeted implementation strategies. Methods: UK stroke rehabilitation teams participated in one-hour workshops discussing PARAS implementation. Transcripts were analysed inductively and deductively using the Theoretical Domains Framework (TDF), facilitating the mapping of behaviour change techniques (BCTs) (Behaviour Change Techniques Taxonomy V1) and implementation strategies (Expert Recommendations for Implementing Change compilation). Results: Five teams (35 healthcare professionals, predominantly physiotherapists) participated. Key themes included system and resource constraints, stakeholder and stroke survivor engagement, intervention adaptation, and knowledge and skills. Nine TDF domains were identified as central to implementation behaviour. Fifteen BCTs and 14 implementation strategies were mapped, with operationalisation methods including training, stakeholder engagement, identifying local determinants, audit, and resource adaptation. Conclusions: This is the first study applying the TDF to understand healthcare professionals’ experiences implementing a physical activity behaviour change intervention post-stroke. Using the TDF enabled systematic mapping of tailored strategies supporting implementation. Findings offer practical solutions for PARAS implementation, with broader applicability across stroke rehabilitation contexts.


Publication metadata

Author(s): Moore SA, Calder J, Folorunsho J, Potthoff S

Publication type: Article

Publication status: Published

Journal: Disability and Rehabilitation

Year: 2026

Pages: Epub ahead of print

Online publication date: 25/03/2026

Acceptance date: 17/03/2026

Date deposited: 14/04/2026

ISSN (print): 0963-8288

ISSN (electronic): 1464-5165

Publisher: Taylor and Francis Ltd

URL: https://doi.org/10.1080/09638288.2026.2649043

DOI: 10.1080/09638288.2026.2649043


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Funding

Funder referenceFunder name
Northumbria University's Internal Funding Scheme 23/24 reference RDF_KE&I S MOORE

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