4. Discussion
stroke
STROKE, RECRUITMENT, HOLIDAYS
This pilot study aimed to evaluate the feasibility of the stroke prevention program MMD for persons with a moderate-to-high risk for stroke in a Swedish primary healthcare setting. The results suggest that MMD is feasible. Recruitment was on time, the randomization process was appropriate, and most participants who enrolled in the study completed it and adhered to MMD. The limited number of dropouts and high response rates for most of the instruments indicate that MMD is acceptable. The results also corroborate the acceptability of MMD and its positive progression in terms of lifestyle goals, as indicated in a previous case study [Recruiting participants in clinical trials can be challenging [Moreover, relevant data collection procedures and measurements are important in clinical trials. A strength of this study was that it studied both objective and subjective measures using an RCT design. Most participants filled out the comprehensive number of questionnaires and participated in monitoring their blood pressure and weight at three time points, showing that the data collection procedures were acceptable and manageable. Although many studies use them, self-reported measures for lifestyle habits have limitations, such as self-report bias, for example, over-reporting and under-reporting of physical activity [Regarding the outcome measurements, there is a need for well-designed interventions exploring the usefulness of different instruments measuring stroke risk, activity patterns, and participation and experiences in prevention and health promotion activities. A strength of this study was that it evaluated the use of COPM [The analysis of stroke risk showed that the IG experienced a greater decrease in overall stroke risk. When controlling for covariates, there was no detected statistical significance, indicating that the stroke risk reduction in the IG remained stable across the analysis; this is a strength of this study, as it shows robustness, albeit with a small sample. It should, however, be noted that the 2018 SRSC [A modified version of the PPR profile [Other important aspects to consider when interpreting the results of this study and planning a full-scale trial include using online or paper surveys, not both; having the same assessors perform the data collection; managing changes in the data collection context during the study period; and striving for similar composition of the IG and CG in terms of stroke risk. In the present study, the IG had more people with high stroke risk than the CG in this study. Although the difference was not statistically significant, it may have affected the results in terms of stroke risk reduction. Moreover, the attendance at one of the MMD prevention program groups was lower than our prespecified goal, which may have affected the results. Measures should be taken in the full-scale RCT to improve adherence (e.g., not scheduling group sessions close to public holidays).