Introduction: Adopting healthy lifestyle behaviors is vital for stroke secondary prevention. However, low- and middle-income countries often lack specific guidelines. High-income countries, such as Ireland, have more extensive research and resources, whereas Brazil, which has a higher stroke burden, frequently relies on external evidence. Understanding the perspectives of individuals post-stroke is essential for implementing contextually relevant interventions. Therefore, this study aims to identify similarities and differences in how individuals post-stroke participating in Patient and Public Involvement (PPI) panels in Ireland (high-income) and Brazil (middle-income) prioritize components to be included in an intervention designed to support the adoption of healthy lifestyle behaviors.
Methods: A descriptive, cross-sectional study was conducted with two PPI panels (five individuals post-stroke from each country), who rated core components across six behaviors (healthy diet, medication adherence, mood management, physical activity participation, safe alcohol consumption, and smoking cessation) as “definitely important”, “maybe important”, or “not important”. Frequencies of responses were calculated per behavior. A cross-country similarity was defined when a majority (>50%) from both panels rated a component the same (“definitely important” or “not important”); otherwise, perspectives were considered different. Descriptive statistics were used.
Results: Most components were rated “definitely important” by >50% in both panels, except for healthy diet. No component was largely deemed “not important”. Differences emerged: only the majority of the Irish PPI panel rated “Have medications review with pharmacist/general practitioner” as “definitely important”; only the Brazilian panel rated all healthy diet, physical activity participation, and smoking cessation components as “definitely important”. Only in Ireland did most PPI members rate 18-50% of the components across all behaviors as “maybe important”.
Conclusions: Similarities point to core priorities for post-stroke lifestyle interventions across contexts, while differences highlight the need for cultural adaptation when transferring interventions from high- to middle-income countries.
