Introduction: Stroke presents a high global burden, particularly in low- and middle-income countries such as Brazil. Stroke secondary prevention, in which the adoption of healthy lifestyle behaviors is a key component, is an important strategy for reducing the global burden of stroke. Effective, evidence-based behavioral interventions are needed to support healthy lifestyle adoption after stroke. The "iHELP Stroke: Improving Health and Lifestyle Programme after Stroke", developed in Ireland, is a multimodal behavioral change intervention designed to support healthy lifestyle adoption after stroke. This intervention was adapted to the Brazilian context, following the ADAPT guidance, and was renamed iVIDAVC (Brazilian Portuguese: Intervenção para Melhorar a Saúde e o Estilo de Vida Pós-AVC; corresponding English title: Intervention to Improve Health and Lifestyle After Stroke). A phase I feasibility study of the adapted intervention was completed in July 2025. The next step is to conduct a pilot randomized clinical trial (RCT) to further assess the feasibility of the study procedures and intervention and to obtain preliminary estimates of clinical outcomes. Objective: To assess the feasibility of a pilot RCT of the iVIDAVC, a Brazilian version of a behavior change intervention to support the adoption of healthy lifestyle behaviors after stroke, and to explore its preliminary effects on goal attainment among individuals with stroke in Brazil. Methods: This is a prospective, pilot RCT (Phase II), with two parallel groups, 1:1 allocation, concealed allocation, and blinded outcome assessment. Twenty-four adults with a clinical diagnosis of stroke, living in the community and reporting the need to change at least one lifestyle-related behavior will be recruited in Belo Horizonte, Brazil, and randomly allocated to an experimental group or a control group (12 participants per group). The experimental group will receive the iVIDAVC intervention, a Brazilian version of a behavior change intervention to support the adoption of healthy lifestyle behaviors after stroke, consisting of one educational session, one individual session, and initially six weekly group sessions, with the possibility of additional group sessions according to participants' needs. The control group will receive the educational and individual sessions and remote support for six weeks. Feasibility outcomes will include recruitment, intervention, outcome measurement, blinding, and costs. Clinical outcomes will include the degree of attainment of behavioral change goals, knowledge about stroke, and self-efficacy for behavior change. Assessments will be conducted at baseline, immediately after the intervention, and four weeks after the intervention. Descriptive and estimation-based statistics will be used, without formal hypothesis testing. Conclusions: This pilot RCT will provide information on the feasibility of the study procedures and the delivery of the iVIDAVC, a Brazilian version of a behavior change intervention to support the adoption of healthy lifestyle behaviors after stroke, as well as preliminary estimates of changes in the GAS T-score. The findings will inform refinements to the intervention and study procedures and support the planning of a future larger-scale RCT.
A non-probabilistic sample of 24 participants will be recruited from the community in Belo Horizonte, Brazil. Recruitment strategies will include the distribution of printed flyers in strategic locations, contact with health professionals and researchers, social media and telephone communication, outreach through stroke support groups, dissemination through university and organizational websites and social media, and invitations to participants from a university extension program. All participants will be informed about the study procedures and, upon agreeing to participate, will provide written informed consent. The intervention and outcome assessments will be conducted in a university laboratory setting. A trained researcher blinded to group allocation will be responsible for collecting sociodemographic, anthropometric, and clinical data at baseline, immediately after the intervention, and four weeks after the intervention. Two independent examiners, also blinded to group allocation, will enter the data into statistical software and verify the presence of missing or inconsistent values. Original paper forms will be stored securely, and electronic files will be accessible only to the research team. All participants will be assigned a unique identification code to ensure anonymity. Statistical analyses will be conducted by an independent researcher who will be blinded to group allocation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
24
The iVIDAVC intervention comprises interactive experiential learning activities coordinated by a physiotherapist, with invited healthcare professionals as guest speakers. The educational session aims to provide knowledge about stroke, signs and symptoms, and lifestyle-related risk factors, as well as the importance of adopting healthy behaviors to reduce the risk of recurrent stroke. The individual session aims to (1) identify the participant's self-reported health status after stroke; (2) increase awareness of lifestyle-related risk factors and support the setting of behavior change goals, using the SMART Goals method; and (3) identify the participant's preferences and ability to participate in the intervention. Each group session includes six components: education, goal setting, physical activity, emotional self-regulation, skills training, and peer learning. These components are addressed across the group sessions and are organized in different ways according to each session.
Participants will receive an educational session and an initial individual session. The educational session will provide information about stroke, signs and symptoms, lifestyle-related risk factors and the importance of adopting healthy behaviors. The individual session will aim to (1) identify the participant's self-reported health status after stroke; (2) identify and increase awareness of lifestyle-related risk factors and establish 3 behavior change goals using the SMART Goals method; and (3) identify the participant's preferences and ability to participate in the program. A physiotherapist will call each participant on a fixed day and at a fixed time agreed upon in advance with the participant. Participants will have the opportunity to clarify any questions regarding the achievement of the goals. The number of telephone support contacts will correspond to the total number of group sessions delivered to experimental group. Participants will not participate in the group sessions.
Universidade Federal de Minas Gerais
Belo Horizonte, Minas Gerais, Brazil
RECRUITINGFeasibility of recruitment
It will be determined by the ratio between the total number of eligible individuals (EI) and the total number of screened individuals (SI) (measure=EI/IS), and by the ratio between the total number of eligible individuals (EI) and the total number of recruited individuals (RI) (measure=EI/RI).
Time frame: Baseline, pre-intervention
Feasibility of intervention (retention)
It will be determined by the ratio between the total number of individuals who completed the proposed intervention program and the total number of individuals who started the proposed intervention program.
Time frame: At baseline and immediately post-intervention
Feasibility of intervention (attendance)
It will be determined by the ratio between the total number of sessions performed and the total number of sessions offered.
Time frame: At baseline and immediately post-intervention
Feasibility of intervention (follow-up of individuals)
It will be determined the ratio between the total number of individuals who remained in the same group to which they were initially allocated until follow-up and the total number of individuals who were allocated.
Time frame: At baseline, immediately post-intervention, and follow-up (4 weeks after the end of the intervention)
Feasibility of intervention (adherence to planned session components)
It will be assessed by comparing the content delivered during each session with the content specified in the intervention protocol. The proportion of planned session components delivered will be recorded.
Time frame: At each intervention session, over the 8- to 12-session intervention period
Feasibility of intervention (safety)
It will be determined by the number and reasons of adverse events (e.g. pain, falls, hospitalization, and death) identified during the period of intervention and follow-up of the individual.
Time frame: During the intervention (8 to 12 sessions) and follow-up (4 weeks after the end of the intervention)
Acceptability of the intervention
Acceptability of the intervention will be assessed using participant feedback on five-point Likert scales, with the following response options: "totally agree", "partially agree", "neither agree nor disagree", "partially disagree", and "totally disagree". Participants will rate the following items: (1) overall satisfaction with the activities conducted by the health professional during the intervention; (2) helpfulness of the educational materials in supporting the adoption of a healthy lifestyle; (3) satisfaction with the overall time required for the intervention, considering the total number of weekly sessions; (4) satisfaction with the duration of the intervention sessions, including 1 hour for the educational session, 1 hour for the individual session, and 2 hours for group sessions; and (5) overall satisfaction with the intervention. These scales were informed by previous studies.
Time frame: Immediately post-intervention
Feasibility of intervention (perceived effectiveness: lifestyle)
It will be determined by the following question: "Comparing how it was before you performed the intervention and now, do you consider your lifestyle to be healthier: strongly agree, partially agree, neither agree nor disagree, partially disagree, strongly disagree".
Time frame: Immediately post-intervention and follow-up (4 weeks after the end of the intervention)
Feasibility of intervention (perceived effectiveness: overall health)
It will be assessed using participant feedback to the following question: "Compared to before participating in the intervention, how would you rate your overall health now?". Participants will rate their perceived change in overall health using five response options: "much better", "somewhat better", "about the same", "somewhat worse", and "much worse". This assessment will capture participants' perception of changes in their overall health following participation in the iVIDAVC intervention.
Time frame: Immediately post-intervention and follow-up (4 weeks after the end of the intervention)
Feasibility of intervention (perceived effectiveness: healthy lifestyle)
It will be assessed using participant feedback to the following question: "Compared to before participating in the intervention, how would you rate your lifestyle now?". Participants will rate their perceived change in lifestyle using five response options: "much better", "somewhat better", "about the same", "somewhat worse", and "much worse". This assessment will capture participants' perception of changes in their lifestyle following participation in the iVIDAVC intervention.
Time frame: Immediately post-intervention and follow-up (4 weeks after the end of the intervention)
Feasibility of measurement
It will be determined by the percentage of clinical outcomes successfully measured (i.e., the ratio between the number of clinical outcomes measured and the number of clinical outcomes proposed to be measured).
Time frame: At baseline, immediately post-intervention, and follow-up (4 weeks after the end of the intervention)
Feasibility of blinding the outcome assessor
The feasibility of blinding the outcome assessor will be determined by the number and percentage of participants for whom the blinded outcome assessor correctly guesses the treatment allocation.
Time frame: Immediately post-intervention and follow-up (4 weeks after the end of the intervention)
Cost
Costs associated with staff training (e.g., materials and transportation), recruitment (e.g., telephone calls and printing of folders), screening, assessment of inclusion and exclusion criteria, outcome assessment (e.g., transportation costs for participants and staff, printing of assessment materials, and material costs), and intervention delivery (e.g., telephone calls) will be recorded.
Time frame: From the beginning of the study planning through the completion of the intervention and follow-up (4 weeks after the end of the intervention)
Attainment of behavioral change goals
Goal Attainment Scaling (GAS). The GAS T-score will be used to assess the degree of attainment of the participant's behavioral change goals. Changes in the GAS T-score will be assessed from baseline to post-intervention and from post-intervention to the 4-week follow-up to determine whether goal attainment is maintained, increased, or decreased over time.
Time frame: At baseline, immediately post-intervention, and follow-up (4 weeks after the end of the intervention)
Knowledge about stroke
Knowledge about stroke will be assessed using six questions addressing participants' knowledge of stroke, its signs and symptoms, risk factors for stroke occurrence, the possibility of experiencing a recurrent stroke, the role of healthy lifestyle behaviors in reducing the risk of recurrent stroke, and how to establish goals to maintain a healthy lifestyle. Participants will provide a yes/no response to each question and describe what they know about each topic. Changes in knowledge will be assessed from baseline to post-intervention and from post-intervention to the 4-week follow-up.
Time frame: At baseline, immediately post-intervention, and follow-up (4 weeks after the end of the intervention)
Self-efficacy for behavior change
Self-efficacy for behavior change will be assessed using five statements addressing participants' perceived ability to independently maintain a healthy lifestyle, establish goals, develop action plans to achieve healthy lifestyle goals, develop coping strategies to overcome barriers to maintaining a healthy lifestyle, and self-monitor and record their lifestyle behaviors. Each statement will be rated on a five-point Likert scale ranging from "strongly agree" to "strongly disagree." Changes in self-efficacy will be assessed from baseline to post-intervention and from post-intervention to the 4-week follow-up.
Time frame: At baseline, immediately post-intervention, and follow-up (4 weeks after the end of the intervention)
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