The adaptation of a co-designed, evidence-based stroke secondary prevention intervention for an Irish stroke support organisation

Background/Objectives Secondary prevention is essential to improve outcomes after stroke, with lifestyle modification shown to reduce cardiovascular risk factors. However, access to structured lifestyle supports post-stroke remains limited. This paper describes the systematic adaptation of The Improving Health and Lifestyle Programme (iHeLP), a co-designed, theory- and evidence-informed secondary prevention intervention, for implementation within an Irish stroke support organisation. Methods The ADAPT guidance was followed to systematically adapt iHeLP for implementation within the Irish Heart Foundation. Four stages were undertaken: i) assessment of the intervention-context fit; ii) planning and undertaking adaptations; iii) piloting and evaluation; iv) implementation planning. The process involved collaboration with organisational stakeholders, a panel of people with lived experience of stroke and caregivers, and a member of the original intervention development team. The Model for Adaptation Design and Impact (MADI) was used to support transparent reporting. Results iHeLP demonstrated strong alignment with existing Irish Heart Foundation services. Key implementation considerations related to workforce capacity, resource availability, and service delivery models. Planned adaptations focused on intervention format, delivery, and implementation while maintaining core intervention functions. Pilot testing further informed reactive adaptations to enhance intervention feasibility, acceptability, and sustainability. Conclusions This article offers insights into the systematic adaptation of a lifestyle modification intervention for delivery within a stroke support organisation. This work represents an important step toward expanding access to secondary prevention supports for stroke survivors in Ireland. The paper provides a structured template and practical insights into adapting evidence-informed interventions for community-based, resource-constrained settings, that can be replicated for other populations, services and behaviour change interventions.