ABSTRACT NUMBER: ESOC2026A1596 WHAT DRIVES INTENTIONS TO CHANGE BEHAVIORS FOR STROKE PREVENTION? THE ROLE OF BEHAVIORAL BELIEFS

Abstract Background and aims Approximately 80% of all strokes are preventable through modification of risk factors, yet achieving and sustaining behavior change remains challenging. We aimed to identify which behavioral beliefs are most strongly associated with intentions to engage in stroke-prevention behaviors. Methods We conducted a survey in a U.S. population-representative sample recruited via Prolific, an online platform for paid study participation (prolific.co). Seventeen stroke-related health behaviors (e.g., diet, physical activity, sleep) were assessed using a validated instrument capturing modifiable risk factors. For each behavior, participants rated future intention to engage and seven behavioral beliefs—capability, difficulty, social norms, social approval, positive personal impact, negative personal impact, and perceived brain health impact—on 7-point Likert scales. Associations between z-standardized beliefs and intentions were examined using adjusted linear mixed-effects regression models. Results A total of 370 participants completed the survey (mean age 47.6 years; 49.7% female). Across all behaviors, participants reported higher intended future engagement. The strongest predictor of intention was perceived positive personal impact (β per SD: 0.25 [95% CI: 0.22, 0.28]; p<0.001), followed by brain-health impact (0.20 [0.17, 0.24]; p<0.001), capability (0.17 [0.14, 0.20]; p<0.001), social approval (0.16 [0.13, 0.19]; p<0.001), and social norms (0.07 [0.04, 0.10]; p<0.001). Negative personal impact was inversely associated with intention (-0.09 [-0.12, -0.05]; p<0.001). Conclusions Across stroke-related health behaviors, perceived positive personal impact, brain impact, and capability emerged as the strongest drivers of behavioral intentions. These findings suggest that behavioral interventions prioritizing personally meaningful benefits and capability enhancement may represent effective strategies for modifiable risk factor control for stroke. Conflict of interest Emily Falk serves on the scientific advisory board for Kumanu. Jonathan Rosand discloses funding from the US National Institutes of Health and the American Heart Association. Christopher Anderson discloses grants from US National Institutes of Health, American Heart Association, and Massachusetts General Hospital, sponsored research support from Bayer AG, and consulting for ApoPharma and MPM BioImpact. Evy Reinders: nothing to disclose. Alyssa Sinclair: nothing to disclose. Tamara Kimball: nothing to disclose. Savvina Prapiadou: nothing to disclose. Marie-Gabrielle Duperron: nothing to disclose. William Brebner: nothing to disclose. Niklas Jung: nothing to disclose. Sanjula Singh: nothing to disclose. Figure 1 - belongs to Results