Cardiovascular risk management through a community-based digital health stroke education platform (Love Your Brain): a multi-arm randomized controlled trial.
Abstract
Background
Stroke affects one in four people globally, highlighting the need for novel approaches to primary prevention. The Love Your Brain digital platform comprises an online course and text messages to improve stroke knowledge and motivate behavior change for stroke prevention.
Aims
To evaluate the efficacy of the platform over 12 weeks in increasing medical practitioner visits for cardiovascular risk assessment/management.
Methods
We conducted a single-blinded, multi-arm randomized controlled trial. Eligible participants were community-dwelling Australians aged ≥45 years with no history of cardiovascular events. Participants were randomized (1:1:1) to interventions (either online course or text messages) or control, stratified by age and gender. The primary outcome was a change from baseline to 12 weeks in self-reported medical practitioner visits for cardiovascular risk assessment/management. Secondary outcomes were knowledge of stroke, uptake of risk-modifying behaviors, and medication adherence. Log-binomial/generalized linear model regression was used, adjusting for stratification variables. Analysis was based on intention-to-treat.
Results
941 participants (median age 67 years; 82·4% women) were randomized between 18 Feb 2025 and 17 Sep 2025 to control (n=311), online course (n=318) or text messages (n=312). At 12 weeks, 82.6% completed follow-up. Self-reported visits to a medical practitioner at 12 weeks exceeded those of the control (29·0%) in the text message arm (41·3%; RR: 1·43, 95% CI: 1·14-1·80, p=0·002), but not the online course arm (31·2%; RR: 1·08, 95% CI: 0·83-1·40). Stroke knowledge increased in both intervention arms (Online: Coeff: 1·13, 95%CI: 0·75-1·50; Text message: Coeff: 0·58, 95%CI: 0·19-0·96) compared to the control. No differences were observed for other outcomes.
Conclusions
The text message intervention increased medical practitioner visits for cardiovascular risk assessment/management among community-dwelling adults without prior cardiovascular events. The online course was ineffectual, potentially due to low completion. The text message intervention warrants scale-up to support primary stroke prevention. REGISTRATION ACTRN12625000124437.