Development of a digital, self-guided return-to-work toolkit for stroke survivors and employers using intervention mapping

Stroke incidence is rising among working-age adults in high-income countries. Employers often lack knowledge and skills to support return-to-work post-stroke. In the United Kingdom, nearly 40% of stroke survivors stop working. Vocational rehabilitation is rarely accessible, and self-guided resources often lack tools to support practical application. This study developed a self-guided return-to-work toolkit for stroke survivors and employers. Steps 1–4 of the six-step Intervention Mapping approach were followed. Intervention goal, content, and design were informed by three online workshops with employers (n = 12) and meetings with an advisory group (n = 20), including stroke charity and trade union representatives, stroke survivors, healthcare professionals, and experts in human resources and vocational rehabilitation. Theory-based pretesting (task-based usability review, advisory group discussions) was shaped by prototype review with advisory group members, including employers (n = 4), stroke survivors (n = 7), and healthcare professionals (n = 4). Framework analysis was used to structure feedback related to acceptability, ease of use/learnability, accessibility, inclusivity, perceived usefulness, and technical or environmental issues. No personal data were analysed. The toolkit aims to empower stroke survivors and employers to plan and manage a sustainable return-to-work post-stroke. It exists as two Xerte eLearning packages, with accessibility features such as screen reader compatibility and keyboard navigation. The toolkit contains theory- and evidence-based content for a) stroke survivors and b) employers, and includes downloadable PDF tools. Stroke survivor-focused content provides guidance on identifying and disclosing support needs to employers. Employer-focused content guides employers in increasing and maintaining understanding of stroke survivors’ work abilities, and implementing and monitoring tailored reasonable adjustments. Pretesting indicated the toolkit is comprehensive, empowering, and fosters open communication, offering key information and practical tools. Minor refinements and technical improvements were suggested. This toolkit addresses a gap in return-to-work guidance in the United Kingdom. Refinement, testing, and evaluation in real-world settings are needed.Author summary: More working-age people are having strokes, and many struggle to return to work afterward. In the United Kingdom, nearly 40% of stroke survivors stop working altogether. Employers often don’t know how to help, and support services are limited or hard to access. In this project, we worked closely with stroke survivors, employers, healthcare professionals, and other experts to design a toolkit to guide employees and employers in planning a stroke survivor’s return to work. We created two interactive online learning packages—one for stroke survivors and one for employers. Each offers practical advice and downloadable tools, such as how to talk about support needs, or make appropriate changes at work. We asked a group of stroke survivors, employers, and healthcare professionals to look at the toolkit and give feedback. The group reported that the toolkit content was clear, practical, and helpful, and that it encouraged open and honest communication. They suggested a few small changes and technical improvements. We believe this toolkit could make a difference for many people attempting to return to work after a stroke. Our next step is to make the suggested changes, and test how well it works in real-world settings.