{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:33:07Z","timestamp":1787581987745,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Often people experience ongoing health challenges after stroke. The Australian Stroke Clinical Registry collects patient\u2010reported outcomes after stroke. Many patients report challenges that are potentially addressable through additional support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To co\u2010design a registry\u2010based, hospital\u2010initiated, follow\u2010up service for people who report major health\u2010related challenges between 90 and 180 days after their stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Iterative, consensus\u2010based methods were used to co\u2010design a follow\u2010up service intervention including eligibility criteria, clinical protocol (consultation\/communication forms and pathways) and implementation requirements (e.g., training manual) (May 2022\u2013March 2023). Stakeholders, including Australian\u2010based clinicians providing stroke care, researchers and people with lived experience of stroke, were involved in each stage. Data collection: Stage 1 (development), (i) scoping survey; (ii) two consensus meetings; (iii) interviews with key informants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093); (iv) online modified Delphi survey; Stage 2 (testing and finalisation), (v) piloting of the follow\u2010up service intervention at one hospital, with service coordinator\/study team interview and participant satisfaction surveys and; (vi) final review (modified Delphi survey). Consensus was defined in the modified Delphi surveys as \u2265\u200980% \u2018agreement\u2019 or verbal consensus via open voting during meetings. Additional recommendations from each step were iteratively incorporated to refine the intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Scoping survey results (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200941\/108 respondents, 38% response rate) highlighted the need for broad inclusion criteria and the involvement of carers\/support person and general practitioners. During the consensus meetings (16\/18, 89% stakeholders attended at least one), verbal consensus was achieved for the eligibility criteria, and additional recommendations were made for the referral report and components within the clinical protocol and training manual. After the final Stage 1 modified Delphi survey (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910, two cohorts), 70%\u2013100% consensus was achieved for the referral report, clinical protocol components and training manual, which were then piloted with six eligible participants. Feedback from the pilot testing (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093 coordinator\/staff interviews;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095 satisfaction surveys) led to further clinical protocol modifications. Agreement was reached for all additional recommendations during the final modified Delphi survey round (16\/29 respondents, 55%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We describe an iterative, consensus\u2010based co\u2010design process which resulted in a novel, registry\u2010based follow\u2010up service intervention for people living with stroke reporting major health challenges. A feasibility randomised controlled trial is the next stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>People with lived experience of stroke, including their family\/caregivers, actively participated throughout the co\u2010design process to develop and test the follow\u2010up service intervention. There was lived experience representation with scoping survey responses, as well as within the working group and independent review group who were involved with the consensus meetings and modified Delphi process. Survey feedback from people with stroke who piloted the developed service intervention was also integral to informing the final service intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70474","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T18:17:35Z","timestamp":1761761855000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Co\u2010Design of a Registry\u2010Based Tailored Follow\u2010up Service Intervention for People Living With Stroke: A Multiple Method Consensus Approach"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3332-5357","authenticated-orcid":false,"given":"Tara","family":"Purvis","sequence":"first","affiliation":[{"name":"Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health Monash University Clayton Victoria 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