Barriers and Enablers for Implementing Self-Management Support for Stroke Survivors: A Mixed-Methods Systematic Review

Background: Stroke may pose significant challenges to individuals and healthcare systems worldwide, and there is a clear need to understand ways to provide effective self-management support. This systematic review aims to identify barriers and enablers for the implementation of self-management support for stroke survivors across various settings. Methods : We conducted a mixed-methods systematic review following PRISMA guidelines, searching CINAHL, Embase, Medline, and Scopus for studies on self-management support with long-term follow-up. The Consolidated Framework for Implementation Research (CFIR) guided our narrative synthesis. Results : After screening 7275 studies and rigorous selection criteria, 37 articles were included. The findings revealed that the implementation of self-management support interventions for stroke survivors is influenced by various enablers and barriers, including training for healthcare professionals, participant motivation, and tailored support. Notable barriers included design and compatibility issues, funding constraints, and local context challenges. Conclusions : Effective self-management interventions must be customized to meet the diverse needs of stroke survivors. Enhancing sustainability and impact requires ongoing support, such as booster sessions and community resources, along with robust evaluation methods. Developing objective measures to complement self-reported data is essential for providing reliable insights and meaningful and effective self-management support. Systematic review registration: This review is registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42024508432.