Transforming Stroke Intervention Through Digital Health and Person-centered Navigation: A Deeper Dive into the Kandu Health Pilot Study

Research Objectives: Stroke poses a significant burden on individuals, families, and healthcare systems with high rates of complex needs and associated costs. Kandu HealthTM, a person-centered digital health platform, offers personalized support for stroke survivors through remote clinical guidance and curated educational content.

1. To review post-discharge stroke-related health and behavioral health needs to determine program utilization
2. To identify thematic perspectives to categorize the needs of stroke survivors and care partners
3. To describe demographic and social determinants of health (SDOH) that impact participant outcomes

Design: a mixed-methods, exploratory design

Setting: A digital outpatient platform for stroke survivors to guide recovery via intuitive applications, a navigator, and support groups. Focus groups were conducted via semi-structured interviews.

Participants: Participants were 41 unique survivors (female 51.2% (n=21); male 48.8% (n=20) and 9 care partners who participated in a 90-day comprehensive post-stroke program . The average age of participants was 59 years (median: 63 years). Over 50% of participants were non-white. Enrollment Modified Rankin Scale (mRS) ranged from mRS 1 to mRS 5 with 26.8% mRS 1, 24.4% mRS2, 24.4% mRS 3, 19.5% mRS 4 and 4.9% mRS 5.

Interventions: Kandu Health delivers tech-enabled healthcare services, providing support during community reintegration. Survivors received digital education, counsel, and resource navigation.

Main Outcome Measures: Demographic and clinical metrics, and transcribed audio recordings were analyzed.

Results: This group had an average of 12 navigator touchpoints over the course of 12 weeks with an average of 7.65 hours of one-on-one navigator time. The average number of SDOH needs identified for this cohort was 3.1. Mental health was the most frequently identified need (43.9%), followed by financial strain (34.1%), family/community support (31.7%), and living situation and transportation (29.3%). Focus group themes included (1) Multi-faceted Therapeutic Support, (2) Educational Content & Services, (3) Triaging/Clinical Care Guidance, (4) Behavioral Health Support, (5) Connectivity/Community, (6) Programmatic Value, (7) Constructive Feedback/Future Opportunities.

Conclusions: Through a comprehensive examination of participant perspectives and outcomes, this study provided insights into the effectiveness of a digital health and clinical navigation platform targeting enhancement of stroke recovery and person-centered care. The multi-faceted therapeutic program addressed core themes known to impact patient and care partner experiences, such as access to comprehensive educational resources, real-time clinical triaging during a vulnerable timepoint in patient recovery, intervention compliance, and SDOH and behavioral health needs. Findings may inform future interventions and initiatives aimed at improving stroke management and reducing healthcare disparities.

Author(s) Disclosures: Kandu financial relationships: Lauren Sheehan, Puja Gohel, Tailar Jonson, Jeffrey Wertheimer