Mehr als eine Trainings-App: Individuelles Coaching per Messenger als Unterstützung für app-basiertes Training von Schlaganfall-Betroffenen

Introduction
A long-term physically active lifestyle is an important goal in the movement therapy rehabilitation of patients with neurological diseases (e.g. stroke). To achieve this goal, measures are primarily implemented in medical facilities, but rarely outside the medical setting (e.g. at home). However, sustainable effects can be expected above all when behaviour is integrated into the everyday life of those affected. There, many affected persons are confronted with psycho-social barriers that prevent the implementation of physical activity or training in everyday life. Effects from regular care may thus be lost again.
One means of overcoming psycho-social barriers in the implementation of training at home is the use of digital coaching to accompany the training. In this way, coaching is possible when it is needed most (e.g. overcoming everyday volitional obstacles). This is exactly when the digital coach enables immediate, informative and emotional support. The aim of this study is to develop a theory-based concept for digital coaching that helps stroke patients in everyday life to implement an app-based training programme despite psycho-social barriers.
Concept
The concept of digital coaching is based on the Rubicon model (Heckhausen et al., 1987) and the Health Action Process Approach (Schwarzer et al., 2008). Both models distinguish behavioural changes into a motivational part (intention formation) and a volitional part (intention formation, behaviour initiation and maintenance). In the motivational part, digital coaching helps to (re-)update and strengthen intentions to act (e.g. information about positive behavioural consequences). In the volitional part, the digital coach addresses the patient's action plans (e.g. embedding them in everyday routines) and counteracts current volitional problems (e.g. encouragement, affirmation).
Approach
The digital coaching supports the use of an accessible training app for stroke victims. The participants receive a 6-week training plan in the app. The coaching takes place via Messenger. This messenger coaching (cf. Kleinert et al., 2022) takes place through reactive push and pull messages. The participants are reminded of the physical activity, the background of the training and its meaningfulness are explained (push). In addition, current questions and implementation problems of the participants are answered or solved by the digital coach (pull).
Outlook
The concept has already been tested in a feasibility study with stroke patients. However, current work should show to what extent and in what way messenger coaching can increase compliance to the use of training apps or other training recommendations. The extent to which certain mediating variables are improved by messenger coaching (e.g. self-efficacy, motivation) plays a special role here. Furthermore, the influence of different moderators will be considered (e.g. social support and the coaching relationship).