Intervention
stroke
STROKE
The researcher assisted caregivers in the intervention group to install the SRA™ app, and provided individualised training on how to use the app. They had free access to the app including the health education sections during the intervention period and also received the pamphlet. Caregivers could communicate with the care management team about the app through WhatsApp or email.The care management team included four members—one medical officer, two staff nurses, and one research assistant. The team received training from the researcher prior to commencement of the trial. The team performed the following functions: provided guidance when required to ensure that the app functioned well, conducted interviews with participants regarding lifestyle according to LS7, tracing blood investigations and informing participants. At baseline, all participants answered the questions in the application, with minimal assistance from researcher. Their absolute and relative risk of getting stroke for the next 5- and 10-years’ time was automatically estimated and standard medical care (motivational education) according to the app-based information was given for those at risk. Standard medical care was defined as treatment provided at primary care level according to Malaysian Clinical Practice Guidelines from Academy of Medicine Malaysia and Ministry of Health (MOH), Malaysia. Standard medical care was given at primary care clinic by registered doctors to all study participants. In addition, participants assigned to the app were able to calculate their own stroke risk and had access to self-help advice embedded in the app and how to act on high-risk domains. The main benefit for interventional group was the ability to learn more about their individual stroke risk with additional opportunity to save their stroke risk profile and monitor changes in their stroke risk over time. Reminders on managing their stroke risk such as exercise and adhering to medication was accessible via the app. Participants in the control group were expected to act on reducing their known risk of getting stroke according to the standard medical care only. Both control and interventional groups was assessed again after 12 weeks by filling up the questionnaire either by email or phone call. During exit assessment only BMI, BP, lifestyle components such as self-reported physical activities were assessed. Due to financial and time constraints, repeat blood investigations (i.e., total cholesterol and fasting blood sugar levels) were not performed (Fig. Study flow chart (CONSORT protocol)The trial was prospectively registered in the Australia-New Zealand Clinical Trial Registry (ACTRN12618002050235, 21/12/2018).