Adherence to and Engagement With an mHealth Physical Activity Intervention After Mild Stroke or Transient Ischemic Attack: Secondary Analysis of a Feasibility Randomized Controlled Trial.

Adherence to supervised mHealth support was high for both exercise and counseling sessions during the 6-month intervention.

• Attendance at supervised exercise sessions was 79%.
• Attendance at counseling sessions was 98%.
• Of 57 participants enrolled, 51 (89%) completed the intervention.
• The average age was 71 years, 34/51 (67%) were female, and 47/51 (92%) had mild stroke symptoms.

Engagement with self-managed mHealth support was high during the intervention period but declined substantially after the intervention ended.

• App engagement during the intervention period was 83%.
• App engagement during the postintervention period declined to 38%.
• App engagement was measured by weekly interactions with self-managed mHealth support during and after the intervention.
• The postintervention period consisted of 6 months of access to self-managed mHealth support following the 6-month supervised intervention.

A larger proportion of females demonstrated high adherence to the intervention compared to males.

• 77% of females (24/31) demonstrated high adherence compared to 23% of males (7/31).
• This difference was statistically significant (χ²₁=4.1; P=.04).
• High adherence was defined as ≥80% attendance.

High adherence during the intervention was associated with maintained physical activity between baseline and the 6-month follow-up.

• High adherence (≥80%) during the intervention was associated with maintained physical activity (OR 12.07, 95% CI 2–72.76; P=.01).
• Maintained physical activity was defined as >7000 steps per day.
• Physical activity was measured using accelerometers at baseline and at 6- and 12-month postbaseline.
• Logistic regression analysis was used to examine the associations.

High app engagement during the postintervention period was associated with maintained physical activity between the 6- and 12-month follow-up.

• High app engagement (≥80%) during the postintervention period was associated with maintained physical activity (OR 5.10, 95% CI 1.02–25.52; P=.05).
• This association was observed specifically between the 6- and 12-month follow-up period.
• Maintained physical activity was defined as >7000 steps per day.
• This was a secondary analysis of data from the experimental arm of a feasibility randomized controlled trial.

The study was a secondary analysis of the experimental arm of a feasibility randomized controlled trial examining an mHealth version of the i-REBOUND intervention.

• The experimental group received a 6-month mHealth version of the i-REBOUND intervention including supervised mHealth support for physical activity and behavior change.
• This was followed by a 6-month postintervention period with access to self-managed mHealth support.
• The control group received mHealth consultations via video conferencing.
• The study enrolled 57 participants with mild stroke or TIA.