503 Implementation, Process, and Preliminary Outcome Evaluation of Two Community Programs for Persons with Stroke and Their Care Partners Maria P.J. Huijbregts, Anita M. Myers, David Streiner, and Robert Teasell Purpose: This evaluation compared a new self-management program with land and water exercise (Moving On after STroke or MOST) to a standard education program (Living with Stroke or LWS). Participants: Of 30 persons with stroke (average age 68 and 2 years post stroke), 18 selected MOST and 12 chose LWS. Sixteen care partners participated. Method: Assessments at baseline, program completion, and 3-month follow-up included the Reintegration to Normal Living (RNL) Index, Activity-specific Balance Confidence (ABC) scale, exercise participation, and goal attainment (for the MOST group). Program delivery costs were calculated and focus groups conducted to examine participant expectations and experiences. Results: Social support was an important benefit of both programs, but only MOST participants improved significantly on the RNL (p < .05) and ABC (p < .001). Seventy-eight percent of all short-term personal goals in MOST were achieved, and overall goal attainment was above the expected level. At follow-up, a higher percentage of MOST participants were enrolled in exercise programs (p < .05). Conclusion: Although self-management programs with exercise are more costly to deliver than standard educational programs, these preliminary results indicate that such programs may be more effective in helping persons with stroke and care partners deal with the challenges of living with stroke. Key words: community participation, education, exercise, self-management, stroke Grand Rounds Elliot J. Roth, MD, Editor Maria P.J. Huijbregts, PhD, PT, is Director, Quality, Risk & Patient Safety, Baycrest, Toronto, Assistant Professor, Department of Physical Therapy, University of Toronto, Toronto, and Adjunct Professor, Master of Public Health, Lakehead University, Thunder Bay, Canada. Anita M. Myers, PhD, is Professor, Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Canada. David Streiner, PhD, is Director, Kunen Lunenfeld Applied Research Unit, Baycrest, Toronto, and Professor, Department of Psychiatry, University of Toronto, Toronto, Canada. Robert Teasell, MD, is Professor, Department of Physical Medicine and Rehabilitation, Schulich School of Medicine, University of Western Ontario, London, and Chair-Chief, Department of Physical Medicine & Rehabilitation, Parkwood Hospital, St. Joseph’s Health Care London, Canada. M any people with stroke, even those with apparently minor limitations, report signiicant physical and psycho-social challenges in readjusting to community living following the initial stage of recovery. Such challenges include relearning skills or developing new ways of doing things, pacing, mobilizing social support, accessing resources, and redeining one’s identity, including work, family, and social roles. 1 Long-term restrictions in activity and social participation are not uncommon, even for people with stroke who have good physical recovery 2 ; this in turn may lead to further withdrawal from community participation, depression, and reduced quality of life. 2–4 Although it is recognized that people with stroke and their care partners may require services beyond acute care and rehabilitation, 5 currently there are very few speciic prototypes for effective community programming post stroke, 6 constituting a signiicant gap in the stroke care continuum. The majority of interventions post stroke have focused exclusively on education 7–10 or education in combination with social support or problem solving. 11–16 Even though such programs can increase knowledge, this may not translate into behavior change or improved well-being. 9,17 Based Top Stroke Rehabil 2008;15(5):503–520 © 2008 Thomas Land Publishers, Inc. www.thomasland.com doi: 10.1310/tsr1505-503