Most people living with stroke engage in low levels of physical activity putting them at higher risk of having a second stroke and developing a range of chronic health conditions. Despite their desire to participate in physical activity, numerous barriers exist. Whilst Northern Ireland Chest Heart and Stroke has successfully implemented the Post Rehabilitation Exercise Programme, the challenge arises post-completion, as survivors of stroke struggle to sustain physical activity over the longer term. This study aims to design and test an intervention to support physical activity in the longer term.

The main objective of this study is to understand the perspectives of key stakeholders on the components, structure, and content of a physical activity maintenance intervention, ensuring the intervention is relevant, acceptable, and feasible for all stakeholders. The second objective is to co-design and refine a prototype intervention using an iterative process, actively involving stakeholders in the development and customisation of the intervention to meet their specific needs and preferences. This mixed methods study involving three stages of the DECIPHer co-production include; 1) evidence review/stakeholder consultation, 2) co-production, and 3) prototyping. Stage 1 will consist of multiple focus groups of Post Rehabilitation Exercise Programme (PREP) participants, staff, and health care professionals. Stage 2 aims to co-design the content, structure, and materials of the PREP maintenance programme, building on stage 1 data. At least 10 participants; 2 from each stakeholder group i.e. healthcare workers, PREP staff, and PREP participants, who completed stage 1 will be asked to take part in the second stage. The workshops will aim to discuss intervention content, sturcture, and materials. Stage 3 will be the prototype stage where what is developed in stage 2 is brought forward to the post-PREP groups.

Inclusion Criteria:

• PREP Participants:

  1. Adults 18 years and older with a clinical diagnosis of stroke, currently attending PREP or completed PREP. Adults with communication impairment will be able to participate via alternative methods of communication (e.g., assistive communication device).
  2. Carers who have supported an adult who have a clinical diagnosis of stroke to complete PREP either currently or have completed PREP.

• PREP Staff/Health Care workers:

  1. Currently working for Northern Ireland Chest Heart and Stroke as a care coordinator role or PREP delivery physiotherapist
  2. Minimum experience of 12 weeks involvement in PREP. Or
  3. Have experience of supporting people with stroke to complete physical activity within the community setting e.g exercise, health, voluntary and statutory organization staff. (There is no minimum amount of experience required (i.e. even if they have supported one person, they can still participate) and therefore there is no additional criteria required for these subjects.)

Exclusion Criteria:

• PREP Participants:

  1. Unable to participate in a group based conversation.
  2. Carers who have no knowledge or experience of PREP.
  3. Unable to use/access a digital device with internet access and a microphone (for online focus group only).
  4. Being a member of the advisory board

• PREP Staff/Health care workers:

  1. Experience of supporting people with stroke to complete physical activity within the acute hospital setting only.
  2. Unable to use/access a digital device with internet access and a microphone (for online focus group only).
  3. Being a member of the advisory board