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J Clin Hypertens (Greenwich). 2016 Oct;18(10):1015-1021. doi: 10.1111/jch.12817. Epub 2016 Apr 1.

The Use of Qualitative Methods in Developing Implementation Strategies in Prevention Research for Stroke Survivors in Nigeria.

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Department of Family Medicine and Public Health, University of California, San Diego, CA.
Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria.
Department of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria.
Department of Neurosciences, Medical University of South Carolina, Charleston, SC.


Implementing complex clinical interventions is a key challenge in many global regions. Local communities play a necessary role in enhancing feasibility and strengthening adaptive issues in the design and implementation of stroke interventions in developing countries. Drawing on the knowledge of physicians, patients, and caregivers, the authors employed qualitative methods as a phase 1 strategy to explore the challenges of stroke management and improve the adaptability and efficient delivery of a multimodal preventive intervention for secondary stroke disease in Nigeria. A total of 22 individual interviews were conducted with healthcare professionals, as well as 12 focus groups with patients and caregivers. Findings revealed four operational domains to improve strategies for phase 2 implementation and intervention: (1) barriers influencing optimal adherence in stroke survivors, (2) patient health beliefs and perceptions of patient health beliefs by others, (3) adoption of the "patient report card," and (4) "medical action plan" and family management strategies.

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