• Valerie A Hill, Barbara G Vickrey, Eric M Cheng, Natalie P Valle, Monica Ayala-Rivera, Lilian Moreno, Cynthia Munoz, Heidi Dombish, Annaliese Espinosa, Debbie Wang, Dina Ochoa, Allison Chu, Rebecca Heymann, and Amytis Towfighi.
• Herman Ostrow School of Dentistry, T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California; Rancho Research Institute, Downey, California. Electronic address: Vhill@dhs.lacounty.gov.
• J Stroke Cerebrovasc Dis. 2017 Dec 1; 26 (12): 2806-2813.

BackgroundStroke survivors have high rates of subsequent cardiovascular and recurrent cerebrovascular events, and mortality. While healthy lifestyle practices - including a diet rich in fruits and vegetables, limited alcohol intake, and regular physical activity - can mitigate these outcomes, few stroke survivors adhere to them. Minorities from socioeconomically disadvantaged communities who obtain care in safety-net health systems experience the most barriers to implementing healthy lifestyle changes after stroke.PurposeTo report the design of Healthy Eating and Lifestyle After Stroke (HEALS), a randomized controlled trial (RCT) was designed to test the feasibility of using a manualized, lifestyle management intervention in a safety-net setting to improve lifestyle practices among ethnically diverse individuals with stroke or transient ischemic attack (TIA).MethodsDesign: Pilot RCT.ParticipantsInclusion criteria: 1) Adults (≥40 years) with ischemic stroke or TIA (≥ 90 days prior); 2) English- or Spanish-speaking.SettingOutpatient clinic, safety-net setting.InterventionWeekly two-hour small group sessions led by an occupational therapist for six weeks. The sessions focused on implementing nutrition, physical activity, and self-management strategies tailored to each participant's goals.Main Outcome MeasuresBody mass index, diet, and physical activity.ConclusionsRecruitment for this study is complete. If the HEALS intervention study is feasible and effective, it will serve as a platform for a large-scale RCT that will investigate the efficacy and cost-effectiveness of life management interventions for racially and ethnically diverse, low-income individuals with a history of stroke or TIA who seek healthcare in the safety-net system.Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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