Community-Based stroke prevention interventions: An integrative review

Abstract

Objective: This integrative review aims to synthesize current evidence on the effectiveness and applicability of community-based interventions for stroke prevention. Methods: A systematic literature search was conducted in PubMed, CINAHL, EMBASE, and Scopus for studies published from January 2014 to the present. Eligible studies included community-based interventions targeting adult populations, focusing on primary or secondary stroke prevention. A qualitative synthesis was performed to analyze the intervention strategies and outcomes. The methodological quality and risk of bias in randomized controlled trials were assessed using the RoB 2.0 tool. The search strategy was guided by PRISMA 2020 guidelines to ensure transparency and methodological rigor. Results: Five main categories of interventions were identified: (1) structured health education programs, (2) lifestyle modification strategies including diet and physical activity, (3) interventions led or supported by community health workers, (4) telehealth and digital health tools, and (5) integrated multimodal approaches combining multiple strategies. These interventions were associated with improved stroke-related knowledge, enhanced health behaviors, and better control of modifiable risk factors such as hypertension, diabetes, and obesity. Cultural tailoring, peer support, and community engagement were recognized as essential to enhancing program uptake, adherence, and long-term sustainability. Conclusion: Community-based interventions represent a feasible and effective strategy to reduce stroke incidence and improve population health outcomes. To maximize their impact, programs should be adapted to the specific sociocultural and resource contexts in which they are implemented. Further research is needed to explore long-term effectiveness, scalability, and cost-effectiveness, especially in low- and middle-income settings where stroke burden remains high