Cross-sector collaboration to develop a mobile health solution for promotion of physical activity after stroke or transient ischaemic attack in Sweden

Abstract Background While mobile health (mHealth) shows great potential for providing accessible support for physical activity following a stroke or transient ischemic attack (TIA), it remains rarely utilised in secondary stroke prevention services. The aim was to develop an mHealth intervention through cross-sector collaboration between academia, end-users, and the medical technology industry, to support physical activity engagement in individuals post-stroke or TIA. Methods The intervention was developed through cross-sector collaboration between a project team (two stroke researchers, two physiotherapists with extensive stroke rehabilitation experience and a representative from the medical technology industry) and intended end-users (individuals post-stroke or TIA and physiotherapists). The development process consisted of three phases: 1) startup, prioritisation, and specifications for digitalisation; 2) development of the mHealth prototype; and 3) prototype adaptation based on feedback on end-user workshops. The project team led the entire development process and nine individuals post-stroke or TIA, and ten physiotherapists, participated in Phase 3 workshops. Results Phases 1-2 resulted in the prioritisation and development of exercise videos with diverse models representing various personas within the target population, incorporating diversity in sex, age, and motor impairments. Educational videos were developed to explain the intervention’s rationale, address safety considerations for home exercises, and emphasise health benefits of physical activity for secondary prevention of stroke. Lastly, a self-monitoring prototype for tracking physical activity was developed. Phase 3 workshops resulted in various user requirements for adapting the mHealth prototype, including simplified navigation, larger icons, and a more intuitive interface. Participants in both end-user groups also highlighted the importance of contextual considerations, such as the need for ongoing support to promote sustained physical activity within the mHealth intervention. Discussion The findings underscored the importance of designing an intervention that can meet individual needs and the perceived value of support from a physiotherapist experienced in stroke rehabilitation to build a therapeutic alliance in a digital intervention. Conclusions This iterative collaborative process identified critical contextual factors, user preferences for ongoing support in physical activity, and specific requirements for developing an mHealth intervention. The process included flexible online workshops with app-based activities, enabling interactive discussions with end-users. The project explored challenges and opportunities in adopting digital stroke prevention interventions through cross-sector and international collaboration, offering key lessons on managing expectations, navigating diverse working cultures, and engaging with regulatory bodies. As a result, we developed a mHealth intervention that is now ready for feasibility testing in Sweden.