Introduction: The PERsonalised Knowledge to reduce the risk of Stroke (PERKS-International) trial, assessed if the Stroke RiskometerTM App, which provides individual health data and prevention advice, changed risk factors at 6-months in Australia and New Zealand. We aimed to explore participant experiences to understand the neutral trial result.
Methods: Mixed-method process evaluation included theory-informed participant satisfaction surveys and interviews with purposively selected intervention and control participants. Quantitative data were analysed descriptively, and thematic analysis conducted for qualitative data.
Results: 370/429 intervention and 389/433 control participants completed surveys (63% female, median age 61), with 33 interviews (20 intervention, 13 control; 18 Australia, 15 New Zealand). Key themes identified were: 1) Motivation (participant selection): participants in both groups joined to learn about their personal risk (38%) or to help by supporting medical research (29%), while few were motivated by wanting to make lifestyle changes; 2) Implementation: The ‘hands-off’ approach mimicked real-life but many participants across both groups wanted more support, particularly about managing their risks; 3) App experience (intervention): Although 79% downloaded the App, many found its purpose and functions unclear, resulting in low or inconsistent use and engagement. More personalised and specific information was considered essential; 4) Addressing risk factors: While both groups reported lifestyle changes related to risks, challenges existed with not knowing ‘how to’ change behaviours or ‘addressing barriers’ to change.
Conclusion: We determined several potential factors influencing the neutral trial result. Future strategies should consider participant readiness to change, with tailored individual risk factor modification content and support.