Behavioral Interventions for Stroke Prevention

Abstract

S ocial and behavioral factors, also termed social determinants of health, are increasingly established risk factors for incident and recurrent stroke, both ischemic and hemor-rhagic stroke, yet improvement in addressing these factors remains insufficient. 1 There is a lack of clarity on who should share in accountability for reducing risk (eg, patients, providers , or health systems) and what interventions are practical, cost-effective, and scalable. 2 For the purpose of this review, we will use the definition of an intervention as a set of actions with a coherent objective to bring about change or produce identifiable outcomes. 3 We first review the published literature to summarize the relevant research on previous behavioral interventions for prevention of stroke and other related conditions , the theoretical frameworks underpinning these behav-ioral interventions, and then propose a new conceptual model for more effective implementation of social and behavioral interventions for stroke prevention. Successful implementation will require adequately addressing the known inherent barriers to behavioral interventions and the ambiguity of financial responsibility and accountability among the various stakeholders. Because new tools, such as digital phenotyp-ing, social network analysis, machine learning, and gamifica-tion, have emerged for facilitating, measuring, and improving existing behavioral interventions, a promising new paradigm in behavioral change has emerged.