Reducing risk behaviours after stroke: An overview of reviews interrogating primary study data using the Theoretical Domains Framework Article Swipe
Patricia Hall
,
Maggie Lawrence
,
Thilo Kroll
,
Catherine Blake
,
James Matthews
,
Olive Lennon
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1371/journal.pone.0302364
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1371/journal.pone.0302364
Background Lifestyle changes, in addition to preventive medications, optimise stroke secondary prevention. Evidence from systematic reviews support behaviour-change interventions post-stroke to address lifestyle-related risk. However, understanding of the theory-driven mediators that affect behaviour-change post-stroke is lacking. Methods Electronic databases MEDLINE, Embase, Epistemonikos and Cochrane Library of Systematic Reviews were searched to March 2023 for systematic reviews addressing behaviour-change after stroke. Primary studies from identified systematic reviews were interrogated for evidence supporting theoretically-grounded interventions. Data were synthesized in new meta-analyses examining behaviour-change domains of the Theoretical Domains Framework (TDF) and secondary prevention outcomes. Results From 71 identified SRs, 246 primary studies were screened. Only 19 trials (N = 2530 participants) were identified that employed theoretically-grounded interventions and measured associated mediators for behaviour-change. Identified mediators mapped to 5 of 14 possible TDF domains. Trial follow-up ranged between 1–12 months and no studies addressed primary outcomes of recurrent stroke or cardiovascular mortality and/or morbidity. Lifestyle interventions targeting mediators mapped to the TDF Knowledge domain may improve the likelihood of medication adherence (OR 6.08 [2.79, 13.26], I 2 = 0%); physical activity participation (OR 2.97 [1.73, 5.12], I 2 = 0%) and smoking cessation (OR 10.37 [3.22, 33.39], I 2 = 20%) post-stroke, supported by low certainty evidence; Lifestyle interventions targeting mediators mapping to both TDF domains of Knowledge and Beliefs about Consequences may improve medication adherence post-stroke (SMD 0.36 [0.07, 0.64], I 2 = 13%, very low certainty evidence); Lifestyle interventions targeting mediators mapped to Beliefs about Capabilities and Emotions domains may modulate low mood post-stroke (SMD -0.70 [-1.28, -0.12], I 2 = 81%, low certainty evidence). Conclusion Limited theory-based research and use of behaviour-change mediators exists within stroke secondary prevention trials. Knowledge , Beliefs about Consequences , and Emotions are the domains which positively influence risk-reducing behaviours post-stroke. Behaviour-change interventions should include these evidence-based constructs known to be effective. Future trials should address cardiovascular outcomes and ensure adequate follow-up time.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1371/journal.pone.0302364
- OA Status
- gold
- Cited By
- 3
- References
- 81
- Related Works
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- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4395684316Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1371/journal.pone.0302364Digital Object Identifier
- Title
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Reducing risk behaviours after stroke: An overview of reviews interrogating primary study data using the Theoretical Domains FrameworkWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-04-26Full publication date if available
- Authors
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Patricia Hall, Maggie Lawrence, Thilo Kroll, Catherine Blake, James Matthews, Olive LennonList of authors in order
- Landing page
-
https://doi.org/10.1371/journal.pone.0302364Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1371/journal.pone.0302364Direct OA link when available
- Concepts
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Psychological intervention, Cochrane Library, Systematic review, Medicine, Stroke (engine), MEDLINE, Meta-analysis, Randomized controlled trial, Gerontology, Internal medicine, Psychiatry, Political science, Mechanical engineering, Engineering, LawTop concepts (fields/topics) attached by OpenAlex
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3Total citation count in OpenAlex
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2025: 3Per-year citation counts (last 5 years)
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81Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.Systematic | 46 |
| abstract_inverted_index.addressing | 56 |
| abstract_inverted_index.associated | 117 |
| abstract_inverted_index.behaviours | 294 |
| abstract_inverted_index.constructs | 302 |
| abstract_inverted_index.effective. | 306 |
| abstract_inverted_index.evidence). | 263 |
| abstract_inverted_index.evidence); | 235 |
| abstract_inverted_index.identified | 63, 95, 110 |
| abstract_inverted_index.likelihood | 164 |
| abstract_inverted_index.medication | 166, 221 |
| abstract_inverted_index.morbidity. | 150 |
| abstract_inverted_index.positively | 291 |
| abstract_inverted_index.prevention | 90, 277 |
| abstract_inverted_index.preventive | 6 |
| abstract_inverted_index.supporting | 70 |
| abstract_inverted_index.systematic | 14, 54, 64 |
| abstract_inverted_index.Theoretical | 84 |
| abstract_inverted_index.post-stroke | 19, 33, 223, 252 |
| abstract_inverted_index.prevention. | 11 |
| abstract_inverted_index.synthesized | 75 |
| abstract_inverted_index.Capabilities | 244 |
| abstract_inverted_index.Consequences | 218, 283 |
| abstract_inverted_index.interrogated | 67 |
| abstract_inverted_index.medications, | 7 |
| abstract_inverted_index.post-stroke, | 198 |
| abstract_inverted_index.post-stroke. | 295 |
| abstract_inverted_index.theory-based | 266 |
| abstract_inverted_index.Epistemonikos | 41 |
| abstract_inverted_index.interventions | 18, 114, 152, 205, 237, 297 |
| abstract_inverted_index.meta-analyses | 78 |
| abstract_inverted_index.participants) | 108 |
| abstract_inverted_index.participation | 178 |
| abstract_inverted_index.risk-reducing | 293 |
| abstract_inverted_index.theory-driven | 28 |
| abstract_inverted_index.understanding | 25 |
| abstract_inverted_index.cardiovascular | 147, 311 |
| abstract_inverted_index.evidence-based | 301 |
| abstract_inverted_index.interventions. | 72 |
| abstract_inverted_index.Behaviour-change | 296 |
| abstract_inverted_index.behaviour-change | 17, 32, 57, 80, 271 |
| abstract_inverted_index.behaviour-change. | 120 |
| abstract_inverted_index.lifestyle-related | 22 |
| abstract_inverted_index.theoretically-grounded | 71, 113 |
| cited_by_percentile_year.max | 97 |
| cited_by_percentile_year.min | 96 |
| corresponding_author_ids | https://openalex.org/A5065683077 |
| countries_distinct_count | 2 |
| institutions_distinct_count | 6 |
| corresponding_institution_ids | https://openalex.org/I100930933, https://openalex.org/I142762351 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.8399999737739563 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.82655002 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |