Can Survivors of Stroke Use a Co-Designed Website Aimed at Improving Physical Activity Levels and Diet Quality to Reduce the Risk of Recurrent Stroke? A Feasibility and Usability Study

BACKGROUND: Secondary prevention programs, for modifiable risk factors such as physical inactivity and poor diet, can reduce recurrent stroke risk, but access remains inequitable. To deliver secondary prevention information to more stroke survivors, alternative approaches are needed. The purpose of this study is to evaluate the feasibility and usability of a co-designed website aimed at improving physical activity and diet quality in stroke survivors. METHOD: A pre-post intervention study with, adult stroke survivors, who accessed the i-REBOUND after stroke website for 4 weeks, was conducted. Quantitative and qualitative data were collected. Feasibility, focused on domains of acceptability, demand, and limited efficacy, was assessed using Bowen's Feasibility Framework. Pre-post changes in limited efficacy (self-efficacy) were assessed using paired t-tests, mean differences (MD), and 95% confidence intervals (CI). Usability was measured by the System Usability Scale. Open-ended responses were mapped deductively. RESULTS: Most participants (survey n = 42, interviews n = 7) found the i-REBOUND after stroke website feasible to use. The website was described as easy to navigate with motivating content. Some participants reported improvements in diet and physical activity, but these did not translate into self-efficacy improvements for diet (MD 0.1, 95% CI [-0.1 to 0.3]) or physical activity (MD -0.1, 95% CI [-0.3 to 0.1]). It remains unclear whether having access to a website like i-REBOUND after stroke can support behavior change. CONCLUSION: It is feasible for most stroke survivors to use a website aimed at reducing secondary stroke risk. Further studies are needed to assess the efficacy and effectiveness of such websites in promoting long-term improvements in physical activity and diet quality.