Prevent Second Stroke (P2S): A randomised controlled trial of stroke survivors testing an online program to improve quality of life.

INTERVENTION: Individuals in the intervention group will receive access to an online program called Prevent Second Stroke (P2S). Individuals will be advised to access the program at least once a week, with a training video on how to use the program presented to the individual on first use. Individuals will have access to the online program for 12 weeks, and will be able to access 24 hours a day, 7 days a week during that time. P2S contains evidence‐base techniques and information in six core modules: 1) Blood Pressure, 2) Smoking, 3) Alcohol, 4) Activity, 5) Nutrition, and 6) Feelings and Mood available as icons across the top of the screen, along with Home and My Progress icons. Each health risk behaviour module commences with 2‐3 brief questions regarding the topic of interest (e.g., Blood Pressure: their last blood pressure reading and when they were last screened; Smoking: smoking status, how many cigarettes per day, interest in quitting) in order to provide tailored information to the user. Each module will take approximately 20‐30 minutes to complete. Participants will be asked to set a specific goal at the end of each module and will be provided with information and advice on how to achieve the goal. The information contained in each module is in the form of videos and text based information. Individuals will also be provided with other useful website links to more information. The advice in each module is tailored to accommodate stroke‐related symptoms. Timing data will be collected from the online platform which hosts the program regarding the time spent on program modules. Fortnightly texts and emails will be sent to prompt program access. At present there are no plans to have a member of the research team checking fidelity or adherence to the program, with no plans at present made to analyse timing data. CONDITION: Alcohol consumption Anxiety Depression Nicotine Addiction Physical inactivity Poor diet quality Stroke PRIMARY OUTCOME: Quality of Life (EuroQuol‐5 Dimensions [EQ‐5D‐5L]) SECONDARY OUTCOME: Alcohol consumption (Alcohol Use Disorders. Identification Test – Consumption [AUDIT‐C]) Barthel Index Cost‐effectiveness (Client Service Receipt Inventory [CSRI]) Depression and anxiety levels (Patient Health Questionnaire for Depression and Anxiety [PHQ‐4]) Diet quality (Australian Recommended Food Score [ARFS]) Instrumental Activities of Daily Living [IADL] scales) Physical activity (Godin Leisure Time Exercise Questionnaire [GTLEQ]) Smoking status (Heaviness of Smoking Index (HSI)) hospital re‐admission for all causes (using medical records data) INCLUSION CRITERIA: 1) admitted to an Australian Stroke Clinical Registry (AuSCR) hospital for first episode of care for acute stroke or other indexed stroke event (ischaemic, haemorrhagic, TIA, or undetermined types of stroke will be included) at 6 – 36 months post stroke; 2) sufficiently fluent in English; and 3) sufficiently fluent in internet use via a home device (e.g. computer or tablet device) or willing to use public internet services (e.g. public library).