Feasibility and acceptability of the breakfast group intervention BISTRo for stroke survivors in acute rehabilitation

Objective To examine the feasibility and acceptability of a co-designed breakfast group intervention, BISTRo, delivered within an acute stroke rehabilitation service. Design Multisite mixed-methods feasibility study. Setting Three National Health Service stroke rehabilitation wards in the United Kingdom. Participants Sixteen stroke survivors and 53 multidisciplinary staff from occupational therapy, physiotherapy, speech and language therapy, dietetics, nursing, and psychology. Intervention A structured breakfast group, delivered on five mornings a week over two weeks, integrating social dining, peer support, multidisciplinary rehabilitation, and functional eating and drinking practice. Methods Attendance, attrition, and therapy dose were recorded. Patient-reported outcomes included a self-confidence Likert scale and subscales of the Confidence after Stroke Measure. Semi-structured interviews with stroke survivors and staff focus groups explored acceptability. Qualitative data were analysed thematically using feasibility and acceptability frameworks. Results Sixteen stroke survivors participated across all wards, with high attendance (mean 8.9 sessions/standard deviation 1.45 out of 10), no intervention-related withdrawals, and complete data collection. Fifteen participants improved on the self-confidence measure. Positive attitude scores improved in eight participants, remained stable in five, and declined in three. In interviews with stroke survivors ( n = 12) and focus groups with staff ( n = 21), BISTRo was described as meaningful, confidence-building, and socially supportive. Staff also reported improved interdisciplinary working and manageable resource demands. Conclusions Delivery of the BISTRo breakfast group was feasible and acceptable and warrants further evaluation. Conducting this feasibility study has enabled identification of potential changes to the trial design.