Effectiveness of a Community-Based Stroke Prevention Intervention Among Older Adults at High Risk of Stroke: A Quasi-Experimental Study in China

Objectives To evaluate the effectiveness of a community-based primary health care (CB-PHC) intervention for stroke prevention among older adults at high risk. Methods A quasi-experimental study was conducted in two communities in Xinxiang City, China, including adults aged 60-79 years at high stroke risk. The intervention group (n = 33) received a 12-week CB-PHC intervention based on the World Health Organization (WHO) Technical Package for Cardiovascular Disease Management in Primary Health Care (HEARTS) package and the Innovative Care for Chronic Conditions Framework (ICCCF), while the comparison group (n = 32) received usual care. Outcomes were assessed at baseline and post-intervention using linear mixed models. Results All 65 participants completed the study, with no baseline differences between groups (all P > 0.05). Significant group × time interactions were observed for all outcomes (all P < 0.001). The intervention group showed significant improvements in stroke-related knowledge, self-management, and physiological risk factors, including body-mass index (BMI) (β = −2.91), blood pressure (including systolic blood pressure (SBP) β = −3.82; diastolic blood pressure (DBP) β = −4.25), low-density lipoprotein cholesterol (LDL-C) (β = −0.85), and fasting plasma glucose (FPG) (β = −1.08). Satisfaction with CB-PHC services also increased significantly (β = 1.32). Conclusions The CB-PHC intervention improved behavioral, cognitive, and clinical outcomes, supporting its potential as a scalable strategy for stroke prevention in high-risk older adults.