Abstract Background and aims To improve stroke care across Europe the Stroke Action Plan for Europe (SAP-E) was launched. While the plan outlines key targets and indicators, individual European countries should develop and implement their national stroke action plans (SAP). Despite commitment to SAP-E, there is limited insight into how its objectives are being operationalized within national strategies and which contextual factors shape implementation. This study aimed to explore how national SAPs are developed and implemented within the broader SAP-E context and to identify associated barriers and facilitators. Methods A mixed-methods approach was used. A survey was distributed among 17 national SAP coordinators. The survey included closed and open-ended questions addressing the extent of implementation across all domains of SAP-E, guiding approaches, barriers and facilitators, and recommendations. Subsequently, five semi-structured interviews were conducted and thematically analyzed, coded using the Consolidated Framework for Implementation Research (CFIR). Results Countries differed in SAP development and implementation. Acute care and secondary prevention domains showed most progress, while quality improvement and life after stroke received less attention. Facilitators included political support, early professional involvement, and alignment with existing structures. Barriers included insufficient funding, weak coordination, and lack of monitoring tools. Conclusions This study shows that translating the SAP-E into national strategies requires both political commitment and professional engagement. While progress differs across countries, successful implementation depends on national adaptation of SAP-E goals, structured coordination, and sustainable resources. Ongoing monitoring of the implementation of national plans and sharing lessons among countries will support achieving the objectives of both national plans and SAP-E. Conflict of interest All authors have nothing to disclose.
Erp et al. (Fri,) studied this question.
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