Younger adult women who had a stroke or at high stroke risk: Exploration of their experiences and needs.

Background: Worldwide, women, particularly younger and middle-aged (≤65 years), are disproportionately affected by stroke. Although the adoption of healthy lifestyle habits is integral for stroke risk factor modification, little is known about younger adult women who had a stroke or are at high risk of stroke-their lifestyle-related knowledge, behaviors, associated and influencing facilitators, and barriers to support brain health, which this study aimed to address. Methods: A qualitative interpretivist design was employed that was part of a larger quality improvement mixed-methods study. Data was collected through virtual, semi-structured focus groups. Inductive thematic analysis was performed and analyzed using the intersectionality framework. Results: A total of 11 women comprised the study sample who were of high stroke risk or had a stroke (mean age 53 years, 54.5 % stroke). A total of six themes emerged from the analysis: (1) lifestyle habits supporting holistic post-stroke recovery, (2) parenting-not being the same mother as before, (3) professional expectations-having to leave career behind and pressures to return, (4) societal expectations of women and permission to self-care, (5) psychological safety and comfort from women-centered interventions, and (6) experience in the healthcare system-not feeling seen, heard, or considered as a woman. Conclusions: Study findings have implications on three levels: 1) micro, through the development of intensive, long-term educational, behavioral, peer-led, group-based and theory-informed interventions that focus on holistic and incremental lifestyle changes and involve family and social support; 2) meso, through the use of practical tools in clinical practice, integration of motivational interviewing and health coaching, and services for children in health care and school systems, and 3) macro, through the incorporation of case management and psychosocial support in the current model of stroke care.