Supporting Re-engagement in Life: Coaching to Enhance Participation in Valued Activities Following Stroke

The goal of this clinical trial is to determine whether Occupational Performance Coaching (OPC), a person-centered, strength-based intervention, can improve participation in valued activities among adults who have experienced a stroke and recently completed community- or clinic-based stroke rehabilitation. The main questions it aims to answer are: Does OPC improve performance and satisfaction with participation in personally valued activities? Does OPC improve participation self-efficacy, physical activity, cognition, and emotional well-being compared to an active attention control intervention? Researchers will compare the OPC group to an active attention control group to see if OPC leads to greater improvements in participation and secondary outcomes. Participants will: Be randomized to receive either OPC (delivered virtually, including collaborative goal-setting and problem-solving) or an active attention control intervention. Complete assessments of participation in valued activties, physical activity (using movement sensors), self-efficacy, cognition, and mood immediately after treatment and at 3 months. A subset of 20 participants from intervention group will take part in interviews to share their experiences.

Inclusion Criteria: * Be living in the community (home, retirement home) * Have completed publicly funded rehabilitation * Are 3 to 12 months post-first stroke. * Be able to communicate in English * Have adequate comprehension and memory to participate in the coaching process. (Must have FIM scores of at least 3 (needs assistance less than 50% of the time) for comprehension and memory at the time of discharge from inpatient rehabilitation). Exclusion Criteria: * We will exclude individuals with unstable major psychiatric conditions or neurodegenerative conditions.