Community Health Worker Assisted Task Specific and Cognitive Therapy At Home with Exposure After Stroke

Description

CATCHES is a novel intervention for preliminary testing, integrating Task Specific Therapy at home guided by Community Health Workers (CHW) under supervision of a licensed Physical Therapist (PT) guided by telehealth based Cognitive Behavioral Therapy (CBT) to reduce task specific fears through repetitive exposure and adaptive behavioral activation strategies and facilitate engagement in physical activity. 1. To integrate and establish feasibility of CATCHES intervention. Hypothesis: A multidisciplinary team providing home based TST with exposure therapy tailored to an underserved urban setting will inform a patient-centered behavioral intervention to reduce fear of falling (FOF) among post-acute stroke patients returning home. Feasibility outcomes will include recruitment, retention, and fidelity of implementation. 2. Test effects of the intervention on hypothesized treatment mechanism of fear of falling. Hypothesis: Therapy will reduce task specific fear of falling Primary outcome will be change in Activities-specific Balance Confidence Scale. 3. Explore physical activity measures subjectively and objectively. Exploratory outcomes include pre and post Timed Up and Go test, patient reported outcome surveys and activity as measured by wearable devices.

Conditions

Stroke, Acute Ischemic

Study Overview

Study Details

Study overview

CATCHES is a novel intervention for preliminary testing, integrating Task Specific Therapy at home guided by Community Health Workers (CHW) under supervision of a licensed Physical Therapist (PT) guided by telehealth based Cognitive Behavioral Therapy (CBT) to reduce task specific fears through repetitive exposure and adaptive behavioral activation strategies and facilitate engagement in physical activity. 1. To integrate and establish feasibility of CATCHES intervention. Hypothesis: A multidisciplinary team providing home based TST with exposure therapy tailored to an underserved urban setting will inform a patient-centered behavioral intervention to reduce fear of falling (FOF) among post-acute stroke patients returning home. Feasibility outcomes will include recruitment, retention, and fidelity of implementation. 2. Test effects of the intervention on hypothesized treatment mechanism of fear of falling. Hypothesis: Therapy will reduce task specific fear of falling Primary outcome will be change in Activities-specific Balance Confidence Scale. 3. Explore physical activity measures subjectively and objectively. Exploratory outcomes include pre and post Timed Up and Go test, patient reported outcome surveys and activity as measured by wearable devices.

Community Health Worker Assisted Task Specific and Cognitive Therapy At Home with Exposure After Stroke

Community Health Worker Assisted Task Specific and Cognitive Therapy At Home with Exposure After Stroke

Condition
Stroke, Acute Ischemic
Intervention / Treatment

-

Contacts and Locations

New York

The Neurological Institute of New York, Columbia University, New York, New York, United States, 10032

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Aged over 18 years
  • * Plan for discharge home after stroke and ability to provide consent
  • * Low balance confidence (Activities-specific Balance Confidence \< 80)
  • * Modified Rankin Scale \> 2 at time of enrollment
  • * Severe Stroke (NIH Stroke Scale \> 14 and/or significant aphasia, dysarthria, or cognitive impairment precluding ability to complete study questionnaires as determined by interviewer)
  • * Legal blindness precluding ability to view infographic or education materials
  • * Terminal non-cardiovascular illness (life expectancy \< 1 year)
  • * Co-morbid mental illness requiring hospitalization
  • * Unavailable for follow-up
  • * Non-English and non-Spanish speaking

Ages Eligible for Study

18 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Columbia University,

Imama A Naqvi, MD, MS, PRINCIPAL_INVESTIGATOR, Columbia University

Study Record Dates

2025-05-31