An Iranian Comprehensive Code Stroke Management Program (Icsm); a Mixed-Methods Study Protocol Publisher



Alijanpour S ; Bahramnezad F ; Mowla A ; Dehgahn Nayeri N ; Aghamolki SFH
Source: International Journal of Qualitative Methods Published:2025

Abstract

Background: Stroke is the second leading cause of death both in Iran and worldwide. However, few studies have monitored performance measures within stroke systems of care, revealing low rates of stroke code activation and intravenous recombinant tissue plasminogen activator administration. To explore experiences, barriers, and effective interventions for improving stroke code management this study was conducted. Methods: This study will use a three-phase, exploratory sequential mixed-methods design and followed SPIRIT guideline for reporting protocol study. In first step, data will be collected through interviews with patients or caregivers and stroke code team members. The development phase will involve consultation with a panel of experts. Finally, based on the data from the qualitative and development phases, an optimized intervention will be implemented and evaluated. Participants will be recruited via purposive sampling with maximum variation. The study is scheduled to commence in March 2024 and conclude in December 2024. Results: In the first step, we will deeply explore the rich data about the problem, and challenges. In the second step, we will find the solution and design the intervention based on the data from the first step. Finally, in the third step, we will implement and evaluate the intervention. Conclusion: This approach aligns with current evidence and best practices by integrating qualitative and quantitative methods to inform the development, execution, and evaluation of a tailored intervention. The findings are anticipated to strengthen Iran’s national stroke code program and offer valuable insights into the facilitators and barriers affecting stroke management. © 2025 Elsevier B.V., All rights reserved.