Background
A reported knowledge-to-clinical practice gap has been identified as a contributing factor to reduced access to inpatient rehabilitation for stroke patients with cognitive impairments. Cognitive Orientation to daily Occupational Performance (CO-OP) is a cognitive-strategy based approach used to optimize functional outcomes for stroke survivors with cognitive impairments.  This study aimed at understanding clinicians’ experiences with implementation of CO-OP across five interprofessional stroke rehabilitation settings.
Methods 
A focus group was conducted with interprofessional representatives (N=8) to explore clinicians’ experiences implementing CO-OP. The session was audio-recorded, transcribed verbatim and analyzed using a hybrid thematic approach.  Interactions between themes were mapped to determine the context for CO-OP implementation. Member checking of emergent themes was conducted to ensure that themes were representative of the data. 
Results 
Three themes emerged that represented perspectives of clinicians across all study sites: system influence, development of experiential evidence and clinician behaviours. In the absence of context-specific evidence, clinicians built their own experiential evidence for CO-OP through practice. Clinicians who were willing to try the new approach reported improved patient outcomes, interprofessional communication and client-centered goal setting. System influences impacted the clinician’s willingness to try CO-OP.  However, supportive system context and positive patient outcomes, mitigated reported challenges and supported continued development of experiential evidence.  
Conclusion 	
Attempting to use CO-OP facilitated development of context-specific evidence.  Healthcare system and institutional culture must support clinicians to explore new approaches to optimize integration into practice. Notably, use of CO-OP led to positive patient outcomes, increased clinician knowledge and confidence, improved interprofessional communication and client-centred goal-setting.

CONTEXT-SPECIFIC EVIDENCE DEVELOPED BY CLINICIANS AIDS IMPLEMENTATION OF A COGNITIVE-STRATEGY BASED APPROACH TO STROKE REHABILITATION: COGNITIVE ORIENTATION TO DAILY OCCUPATIONAL PERFORMANCE