1. Introduction to LEAP

2. Objectives Introduction to LEAP and how it works
Objectives and goals of LEAP
LEAP materials
How to market LEAP
Best practices for implementation
Today I am going to introduce the LEAP program and talk about how to implement the program in your facility.

3. What is LEAP?
A structured yet flexible post-stroke education program for stroke survivors and caregivers
Developed by healthcare professionals
Register at stroke.org/LEAP and access all program materials for free
LEAP is a systematic approach to post-stroke education for survivors and caregivers that was developed by healthcare professionals and piloted through several Stroke Center Network facilities from 2009 through We have used the results and recommendations of the pilot programs to further refine the program and are now rolling it out nationwide.
All the materials necessary to host a LEAP program will be available at no cost on our website.

4. Why LEAP? More than 7 million stroke survivors in U.S. and growing
People spend less time hospitalized and in rehab
Additional patient and family education is necessary for better outcomes
Research supports importance of post-stroke education
Well-organized, multidisciplinary education has been shown to improve outcomes
We know that there are more than 7 million stroke survivors in the US and the number is growing daily. Pressures on the healthcare system are both limiting the amount of time that survivors spend in acute care and at the same time expecting better outcomes.
Duncan, Zorowitz, Bates, Choi, Glasberg, Graham, et al. Stroke. 2005;36: e100–e143.
Clarke, Barker-Collo, & Feigin. Top Stroke Rehabil Jan-Feb;19(1):32-9.

5. Community Needs Assessment
Indicates that survivors and caregivers seek out stroke-related information significantly more during rehab and recovery
Stroke awareness significantly increases after stroke
Stroke survivors want to seek out information from healthcare professionals

6. Caregivers/Survivors Who Reported Seeking Out Stroke-Related Information During the Continuum
*Significantly differ at the p < .001 level
^Significantly differ at the p < .001 level
National Stroke Association’s 2013 needs assessment indicated that stroke survivors and caregivers want more information about stroke during recovery and rehabilitation. And 6

7. Stroke Survivors Reported Sources for Stroke-Related Information Before, During and After Their Stroke
They want to receive that information from healthcare professionals. The LEAP program fills that need. 7

8. How does LEAP work? Four modules taught over a few weeks or months
Each module takes about 2.5 hrs. and covers:
Facts about stroke, rehab and secondary stroke prevention
Explains psychosocial aspects of changes in post-stroke life
Information about local and national resources
Living best life after a stroke
Includes recommended timed agenda of presentations and activities
LEAP is designed to be presented in 4 modules over the course of a few weeks or months. Each module is designed to take about 2.5 hours. The 4 modules are structured with a recommended and timed agenda of presentations and activities for each class, but also designed to be flexible to address specific concerns by participants. The specific presentations are designed for delivery by the appropriate healthcare professional and are about 20 minutes in length.
Topics covered include Stroke 101 or what happened, information about rehabilitation, including different types of services to address various needs. The program includes presentations on nutrition, medications post-stroke, on the emotional changes that impact stroke survivors. There is also a section on local and national resources available to stroke survivors and caregivers. The emphasis of the program is on secondary stroke prevention and lifetime recovery.

9. Where Should You Hold LEAP?
Best locations to hold classes include:
Hospital
Rehabilitation center
Health clinic
Participation of healthcare professionals is highly recommended
Rooms should be ADA accessible with accessible restrooms nearby
The pilot programs found that holding the classes in the hospital, a health clinic or rehab center worked best. The two main reasons are that those settings are more likely to be easily accessible for survivors with mobility issue and it makes it easier to facilitate presentations by healthcare professions.

10. LEAP Objectives To enhance participants’: Knowledge
Stroke effects and aftermath
Rehabilitation options
Common psychosocial and emotional responses
Key resources available
Skills—Relationships, self-care and self-advocacy
Adaptive strategies to support activities of daily living
Stress management
Improve language and memory deficits
Attitudes about post-stroke living
Recognize common misconceptions
Value of mutual support among survivors and caregivers
Value of living in the present
Each module of the program has very specific objectives and goals. The objectives and goals of the program are threefold:
First, the main knowledge goals for the program are for stroke survivors and caregivers to understand what happens during stroke and secondary prevention strategies; learn about rehabilitation options and how to manage the physical changes and impact; understand some of the common emotion and psychological changes and responses to stroke; and for survivors and caregivers to learn about the various local and national resources that are available to assist and improve quality of life.
Second, is to enhance survivors skills in relationship to self care and self advocacy. The program will help survivors and caregivers learn methods to manage stress, how to use resources to solve challenges, and some adaptive strategies to support the activities of daily living.
And finally and probably most important is the objective to improve attitudes about post-stroke living, reinforcing the message that recovery is a lifetime journey and helping survivors find joy in their new reality.
One of the main goals of the program is to help survivors and caregivers become aware of how their thoughts, words and actions impact their quality of life. The program talks about how impactful the words that are used can be—for example the difference of thinking of yourself as a stroke victim vs. a stroke survivor.
One of the final exercises of the program uses a wellness wheel detailing 6 aspect of life and asks that the participants identify at least one positive thing in each area that they can do to improve their life.

11. Complimentary registration is required for first time users
Program Materials
Facilitator’s guide
Participant handouts
PowerPoint presentations
Marketing tool kit
Signage
Evaluations
Complimentary registration is required for first time users
All of the materials necessary to conduct the program will be housed at
The site is scheduled to be live at the beginning of August.

12. Facilitator’s Guide Contents
LEAP overview
LEAP learning objectives
Implementation guide for modules
Timed agenda
Talking points
List of supplies to support program
Facilitator tips
Includes an overview of the program, the learning objective, an implementation guide with a timed agenda and recommended talking points for the guest presenters, a list of all supplies you might need and tips on how to facilitate a group.

13. Example of Facilitator Materials
Here is a sample of what the materials look like

14. Handouts A variety of handouts will be available for each module:
Blood pressure log
Registration forms
Stroke quizzes
Meaningful messages
Informational pieces
Evaluations
Certificate of completion
For each module a variety of handouts will be available, these include registration forms, quizzes, a blood pressure log as well as informational pieces, and templates for name tents and certificates of completion. There will also be links to additional resources for survivors and caregivers to place on a resource table in the classroom.

15. Example of Participant Handouts

16. Examples of PowerPoint Presentations
The following have been developed by pilot sites and shared with our LEAP program for ideas:
Stroke 101—What is a stroke?
Recovery and Rehabilitation
Drug Therapies
Wellness Wheel
Nutrition
One of the facilities that participated in the pilot program and that has continued with the program, The University of Colorado Hospital, has graciously allowed us to post some of the PowerPoint presentations that were prepared for specific topics. These can be used by your presenters desired.

17. Review our marketing handouts for more information
Marketing Tool Kit
The kit consists of marketing strategies and templates to ensure success in your community:
Flyer with program details
copy: Initial and Reminder
Press release
PSA language
Sample Facebook post
Art files with logo
Review our marketing handouts for more information
We have also prepared templates of marketing materials that can be customized for your use. These include a flier with program details, suggested copy, a press release, sample FaceBook posts and art files with the logo that can be used to create your own marketing materials.

18. Suggestions for Implementation
Implementation checklist
At least two (2) dedicated facilitators
Stroke coordinator and a therapist (OT/PT/SLP)
Pre-registration if possible
Ideal class size is 20 stroke survivors and their caregivers
Tables in U formation for sessions 1 and 4
Promotes sharing and getting to know each other
We have developed a check list for reference. We know that it may not be all inclusive but it’s a starting point.
The places that the program has been most successful have identified two dedicated facilitators.
Make sure there is some lead time for marketing, securing presenters and preparing materials.
Pre-register participants if at all possible- the ideal class size is 20 stroke survivors and caregivers.
Because of the nature of the sessions, be sure the room that you chose can accommodate having the tables in a U formation for at least the first and last session. That setup is conducive to establishing a safe environment for sharing and getting to know the others in the group.

19. Implementation Cont. Clearly define group norms and expectations
Briefly review previous module at beginning of each class (5 minutes)
Name tents rather than name tags
Provide note cards for participants’ questions
It is important as with any group to clearly define the expectations for participation and sharing, etc.
Briefly review—no more than about 5 minutes- the contents of the previous module at the beginning of each class.
Use name tents rather than name tags- two reasons- you don’t have to worry about them sticking to clothing, the font size can be bigger to facilitate ease in seeing the names.
Provide note cards for participant’s questions. It is important to allow participants to ask questions, however, it is also easy for presenters to be derailed by questions and not cover the topic. Several of the pilot project locations found that asking participants to write down their questions to hold until the end of the presentations worked well. Sometimes the question was answered in the rest of the presentation, sometimes the answer needed to be researched and answered in the next class.

20. Implementation Cont. Resource table in back of room
There are numerous available handouts, not all are applicable to all participants
Only place handouts out which correspond to each module
Wheelchair accessible
Including accessible restrooms nearby
Spread sessions over at least 1 month
Hold programs twice a year
There are so many printed resources available for stroke survivors and caregivers—brochures, fact sheets, catalogues, etc. the pilot sites found that having a resource table in the back of the room worked better than overwhelming the participants with tons of paper. Only pass out the actually handouts—quizzes, etc that are needed in a particular class.
Spread the sessions over at least a month. Lots of information to absorb. Ideally hold the program twice of year, many survivors like to attend more than once to learn more.

21. At each session Registration table Blood pressure check station
Relaxation exercise—start each session with 5 minutes of breathing and clearing the mind
Knowledgeable guest speakers
Comfort break with healthy snacks
Resource Table
A registration table, to provide materials for that class, register newcomers, welcome
A blood pressure station or circulating blood pressure takers—student nurses are a great option
Start each session with a relaxation exercise—5 minutes of breathing and clearing the mind.
Invite knowledgeable guest presenters, be very clear on the amount of time they have for their presentation.
Plan for a comfort break—it’s built into the timed agenda. Provide healthy snacks.

22. Evaluations After each module – for internal feedback
Final evaluation at the completion of all four modules
As with any project continuous improvement is a part of the process. The one thing that National Stroke Association wants back from you is evaluation information. We have developed evaluations for you to do after each session. These are designed for your own internal feedback on presentations, the facility, etc. We also have a final evaluation to be done at the end of the entire program—we would like to have you share those results with us so that we can make improvements in the program and report back to the funders of the program Additionally, there is three month post-program evaluation which will give us information about lifestyle changes, etc made after program participation. This is also information that will be shared with the funders and help to inform improvement in the LEAP program as well as additional stroke survivor and caregiver educational and material development by National Stroke Association.

23. Contact Information
If you have any questions contact: Dawn Lando Coordinator, Survival Programs
Thank you so much for your participation today. If you have any questions or concerns around implementation of the LEAP program feel free to me,
Laura at
or our educational coordinator Valerie at

24. Learn more at stroke.org
THANK YOU!
Learn more at stroke.org
1-800-STROKES
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©2017 National Stroke Association