{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:43:52Z","timestamp":1791499432230,"version":"4.3.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T00:00:00Z","timestamp":1586908800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>\u201cTake Charge\u201d is a novel, community-based self-directed rehabilitation intervention which helps a person with stroke take charge of their own recovery. In a previous randomized controlled trial, a single Take Charge session improved independence and health-related quality of life 12 months following stroke in M\u0101ori and Pacific New Zealanders. We tested the same intervention in three doses (zero, one, or two sessions) in a larger study and in a broader non-M\u0101ori and non-Pacific population with stroke. We aimed to confirm whether the Take Charge intervention improved quality of life at 12 months after stroke in a different population and whether two sessions were more effective than one.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We randomized 400 people within 16 weeks of acute stroke who had been discharged to institution-free community living at seven centers in New Zealand to a single Take Charge session (TC1, n\u2009=\u2009132), two Take Charge sessions six weeks apart (TC2, n\u2009=\u2009138), or a control intervention (n\u2009=\u2009130). Take Charge is a \u201ctalking therapy\u201d that encourages a sense of purpose, autonomy, mastery, and connectedness with others. The primary outcome was the Physical Component Summary score of the Short Form 36 at 12 months following stroke comparing any Take Charge intervention to control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 400 people randomized (mean age 72.2 years, 58.5% male), 10 died and two withdrew from the study. The remaining 388 (97%) people were followed up at 12 months after stroke. Twelve months following stroke, participants in either of the TC groups (i.e. TC1\u2009+\u2009TC2) scored 2.9 (95% confidence intervals (CI) 0.95 to 4.9, p\u2009=\u20090.004) points higher (better) than control on the Short Form 36 Physical Component Summary. This difference remained significant when adjusted for pre-specified baseline variables. There was a dose effect with Short Form 36 Physical Component Summary scores increasing by 1.9 points (95% CI 0.8 to 3.1, p\u2009&lt;\u20090.001) for each extra Take Charge session received. Exposure to the Take Charge intervention was associated with reduced odds of being dependent (modified Rankin Scale 3 to 5) at 12 months (TC1\u2009+\u2009TC2 12% versus control 19.5%, odds ratio 0.55, 95% CI 0.31 to 0.99, p\u2009=\u20090.045).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Confirming the previous randomized controlled trial outcome, Take Charge\u2014a low-cost, person-centered, self-directed rehabilitation intervention after stroke\u2014improved health-related quality of life and independence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration-URL<\/jats:title>\n                    <jats:p>http:\/\/www.anzctr.org.au . Unique identifier: ACTRN12615001163594<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1747493020915144","type":"journal-article","created":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T10:38:20Z","timestamp":1586947100000},"page":"954-964","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":87,"title":["Taking Charge after Stroke: A randomized controlled trial of a person-centered, self-directed rehabilitation intervention"],"prefix":"10.1177","volume":"15","author":[{"given":"Vivian","family":"Fu","sequence":"first","affiliation":[{"name":"Medical Research Institute of New Zealand, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Weatherall","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"McPherson","sequence":"additional","affiliation":[{"name":"Health Research Council of New Zealand, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Taylor","sequence":"additional","affiliation":[{"name":"Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"McRae","sequence":"additional","affiliation":[{"name":"Auckland District Health Board, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Thomson","sequence":"additional","affiliation":[{"name":"Hutt Valley District Health Board, Lower Hutt, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gommans","sequence":"additional","affiliation":[{"name":"Hawkes Bay District Health Board, Hastings, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"Green","sequence":"additional","affiliation":[{"name":"Counties-Manukau District Health Board, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matire","family":"Harwood","sequence":"additional","affiliation":[{"name":"Te Kupenga Hauora M\u0101ori, University of Auckland, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3223-3330","authenticated-orcid":false,"given":"Annemarei","family":"Ranta","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7952-3936","authenticated-orcid":false,"given":"Carl","family":"Hanger","sequence":"additional","affiliation":[{"name":"Canterbury District Health Board, Christchurch, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Riley","sequence":"additional","affiliation":[{"name":"Medical Research Institute of New Zealand, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3030-6062","authenticated-orcid":false,"given":"Harry","family":"McNaughton","sequence":"additional","affiliation":[{"name":"Medical Research Institute of New Zealand, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,4,15]]},"reference":[{"key":"bibr1-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308413"},{"key":"bibr2-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1002\/9780470696361"},{"key":"bibr3-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.605139"},{"key":"bibr4-1747493020915144","unstructured":"Stroke rehabilitation in adults. Clinical guideline [CG162]\n                      . Manchester, UK: National Institute for Health and Care Excellence. 2013."},{"key":"bibr5-1747493020915144","first-page":"CD002925","volume":"1","author":"Outpatient Service Trialists","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr6-1747493020915144","first-page":"CD005066","volume":"5","author":"Ellis G","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr7-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31447-2"},{"key":"bibr8-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1177\/1747493017743061"},{"key":"bibr9-1747493020915144","unstructured":"Fu V.\n                      Taking Charge After Stroke: a novel, community-based intervention to improve the lives of people with stroke\n                      . Doctoral Thesis, Victoria University of Wellington, Wellington, New Zealand, 2019."},{"key":"bibr10-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1080\/09638280410001702414"},{"key":"bibr11-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.55.1.68"},{"key":"bibr12-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrp.2008.09.001"},{"key":"bibr13-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1177\/0269215511426017"},{"key":"bibr14-1747493020915144","doi-asserted-by":"crossref","first-page":"E016512","DOI":"10.1136\/bmjopen-2017-016512","volume":"7","author":"Fu V","year":"2017","journal-title":"BMJ Open"},{"key":"bibr15-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.19.5.604"},{"key":"bibr16-1747493020915144","unstructured":"District Health Boards catchment population, www.health.govt.nz\/new-zealand-health-system\/my-dhb (accessed 29 October 2018)."},{"key":"bibr17-1747493020915144","unstructured":"Stroke Foundation of New Zealand resources for patients, www.stroke.org.nz\/free-resources (accessed 29 October 2018)."},{"key":"bibr18-1747493020915144","unstructured":"McNaughton H, Fu V and Riley J. Take charge booklet and training manual, www.mrinz.ac.nz\/programmes\/stroke (accessed 12 March 2020)."},{"key":"bibr19-1747493020915144","first-page":"61","volume":"14","author":"Mahoney FI","year":"1965","journal-title":"Md State Med J"},{"key":"bibr20-1747493020915144","doi-asserted-by":"publisher","DOI":"10.3109\/03790798509165991"},{"key":"bibr21-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1097\/01.mrr.0000127349.25287.de"},{"key":"bibr22-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.10.1812"},{"key":"bibr23-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/38.3.344"},{"key":"bibr24-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.10.1876"},{"key":"bibr25-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000062554.74615.4C"},{"key":"bibr26-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000064706.35861.B4"},{"key":"bibr27-1747493020915144","first-page":"1414","volume":"27","author":"Thumboo J","year":"2000","journal-title":"J Rheumatol"},{"key":"bibr28-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-9861.2011.00068.x"},{"key":"bibr29-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60584-5"},{"key":"bibr30-1747493020915144","unstructured":"Harwood MLN.\n                      Understanding and improving stroke recovery for M\u0101ori and their Wh\u0101nau\n                      . Doctoral Thesis, University of Otago, 2012."},{"key":"bibr31-1747493020915144","first-page":"CD010442","volume":"8","author":"Fryer C","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr32-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1177\/0269215510394467"},{"key":"bibr33-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1080\/09638280500265961"},{"key":"bibr34-1747493020915144","doi-asserted-by":"publisher","DOI":"10.1177\/0269215508101741"},{"key":"bibr35-1747493020915144","first-page":"9","volume":"127","author":"McNaughton H","year":"2014","journal-title":"NZ Med J"},{"key":"bibr36-1747493020915144","unstructured":"Levack W. Can a \u2018take charge\u2019 intervention reduce incidence of repeat acute exacerbation of chronic obstructive pulmonary disease? 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