Photo Credit: thesomegirl

The following is a summary of “Identifying mediators of healthy lifestyle adoption after stroke: a focus group study using a Theoretical Domains Framework guided analysis,” published in the April 2025 issue of BMC Neurology by Hall et al. 

Lifestyle changes alongside medication help prevent stroke recurrence. Motivation depends on social and cultural factors. 

Researchers conducted a retrospective study on stroke survivors’ experiences in managing lifestyle risks through cognitive, affective, social, and environmental factors. Patient and public involvement (PPI) improved research quality and transparency. 

They conducted eight focus groups (N=35 stroke participants, N=3 carers) using semi-structured questions co-developed with a PPI panel. Purposive sampling ensured representation by location and disabilities. Data were coded inductively and mapped to the Theoretical Domains Framework deductively to identify behavior-change constructs. 

The results showed that participants largely figured out risk-reducing lifestyle changes on their own. Their experiences mapped 10 of 14 TDF domains, with Knowledge and Social Influences as key behavior-change mediators. Goals were rarely discussed, indicating underutilization. Reinforcement and Behavioral Regulation constructs, such as reminders and rules, were valued. Psychosocial challenges, emotional responses, and cognitive difficulties mapped to Memory, Attention & Decision Processes and Emotions domains. Health beliefs, self-identity, and perceived ability to change mapped to Social/Professional Role & Identity, Beliefs about Consequences, and Beliefs about Capabilities. ‘Know how’ for behavior change was largely lacking, with Intentions, Skills, Environmental Context & Resources, and Optimism notably absent from discussions. 

Investigators found the TDF useful in linking stroke survivors’ prevention experiences with behavior-change constructs. Results had theory-driven implications for guiding future interventions in risk reduction. 

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04144-1