Social Learning in a Virtual Environment After Stroke: A Thematic Analysis Of Stakeholder Experiences During The COVID-19 Pandemic

RESEARCH OBJECTIVES: We explored stakeholders’ experiences using videoconferencing to participate in group-based social learning during the COVID-19 pandemic. DESIGN: Qualitative thematic analysis. SETTING: Community-based. PARTICIPANTS: We interviewed 8 community-dwelling low-income adults with chronic stroke (≥ 3 months) and mild-to-moderate disability (NIH Stroke Scale ≤16) who enrolled in the ENGAGE Pilot Study (NCT04019275) during the COVID-19 pandemic. Research staff (n=4), peer facilitators (n=2), and occupational therapist facilitators (n=2) were also interviewed. INTERVENTIONS: ENGAGE blends social learning, guided discovery, and skills training to facilitate community and social participation. The 8-session curriculum was adapted for delivery via videoconferencing during the COVID-19 pandemic. Peer and occupational therapy facilitators led the groups. MAIN OUTCOME MEASURES: Semi-structured interviews were conducted. Interviews were transcribed, annotated, and coded by 3 researchers. Results were member checked. RESULTS: Stakeholders reported that they valued participation in the intervention using videoconferencing and connectedness through shared experiences. Some participants felt more comfortable sharing experiences over videoconferencing than in person. The COVID-19 pandemic prompted participants and facilitators to identify creative approaches to community and social participation. All stakeholders highlighted technical and social components of using videoconferencing that should be included in training at the beginning of remotely delivered interventions. Learning occurred over the duration of the group sessions rather than during one training session. Group facilitators also described strategies for navigating technical challenges and engaging participants during online group sessions. CONCLUSIONS: Group-based interventions delivered via videoconferencing may facilitate valuable social learning experiences after stroke. Videoconferencing training should address technical skills and social expectations. Future research should explore stakeholder preferences for virtual or face-to-face group interventions, virtual group processes, and optimal training strategies to facilitate technology uptake. AUTHOR(S) DISCLOSURES: This research was supported by the following: T32 Precision Lifestyle Medicine and Translational Research (PREMIER) Postdoctoral Training Program (NHLBI T32HL134634); NIH CTSA SPIRiT Award (University of Pittsburgh, UL1 TR001857; Washington University in St. Louis, UL1 TR002345).