{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:59:09Z","timestamp":1785178749688,"version":"3.55.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>We evaluated the efficacy of the Stroke Riskometer mobile phone application to change the Life\u2019s Simple 7 risk factor score in a primary prevention population at 6 months postrandomization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This phase III, prospective, outcome assessor\u2013blinded, 2-arm randomized controlled trial in Australia and New Zealand recruited participants from August 2021 to January 2024. Inclusion criteria: age \u226535 and \u226475 years; \u22652 risk factors; smartphone ownership; and no cardiovascular disease history. The intervention group was given access to the application; the usual care group received one email with generic risk factor information. The primary outcome was the mean between-group difference in Life\u2019s Simple 7 (score 0 [poor] to 14 [ideal], comprising blood pressure, cholesterol, glucose, body mass index, smoking, and physical activity and diet) from baseline to 6 months postrandomization. Secondary outcomes were between-group changes in individual Life\u2019s Simple 7 items. Analyses were performed using intention-to-treat principles with ANCOVA and linear mixed models to examine differences between groups, with prespecified per-protocol and subgroup analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We randomized 862 participants (mean\u00b1SD age, 58\u00b111 years; 63% women; 74% White). At 6 months postrandomization in intention-to-treat analyses, the mean difference between usual care (n=433) and intervention (n=429) groups in the change in Life\u2019s Simple 7 score from baseline was 0.03 ([95% CI, \u22120.19 to 0.25];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.788). Per-protocol analyses (n=320 usual care; n=276 intervention) were similar (mean difference in change, 0.20 [95% CI, \u22120.04 to 0.43];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.106). Compared with usual care in intention-to-treat analyses, the intervention group had a nonsignificant increase in metabolic equivalent of task (metabolic equivalent of task) minutes per week of physical activity (313.42 [95% CI, \u22122.80 to 629.65];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.052), with no differences in other Life\u2019s Simple 7 items.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Among a general population aged 35 years to 75 years with \u22652 stroke risk factors, there was no evidence that having access to the application changed overall Life\u2019s Simple 7 scores at 6-month follow-up. Participants in the intervention group did have a nonsignificant increase in physical activity, compared with the usual care group, after 6 months, but not in other individual risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.anzctr.org.au\/\">https:\/\/www.anzctr.org.au\/<\/jats:ext-link>\n                      ; Unique identifier: ACTRN12621000211864.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.125.054001","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T09:01:02Z","timestamp":1780304462000},"page":"2254-2264","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Randomized Controlled Trial Testing the Efficacy of an mHealth Application to Reduce Risk Factors for the Primary Prevention of Stroke"],"prefix":"10.1161","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5138-2526","authenticated-orcid":true,"given":"Seana L.","family":"Gall","sequence":"first","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (S.L.G., K.C., M.R.N., G.K.)."},{"name":"Epidemiology and Prevention Division, Stroke and Ageing Research, Department of Medicine, Clayton, Australia (S.L.G., A.G.T.), School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6372-1740","authenticated-orcid":true,"given":"Valery L.","family":"Feigin","sequence":"additional","affiliation":[{"name":"National Institute of Stroke and Applied Neurosciences, Auckland University of Technology, New Zealand (V.L.F., S.J.-M., R.V.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0842-6316","authenticated-orcid":true,"given":"Kate","family":"Chappell","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (S.L.G., K.C., M.R.N., G.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8533-4170","authenticated-orcid":true,"given":"Amanda G.","family":"Thrift","sequence":"additional","affiliation":[{"name":"Epidemiology and Prevention Division, Stroke and Ageing Research, Department of Medicine, Clayton, Australia (S.L.G., A.G.T.), School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4430-3276","authenticated-orcid":true,"given":"Timothy J.","family":"Kleinig","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Adelaide, South Australia, Australia (T.J.K.)."},{"name":"Department of Neurology, Royal Adelaide Hospital, South Australia, Australia (T.J.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8162-682X","authenticated-orcid":true,"given":"Dominique A.","family":"Cadilhac","sequence":"additional","affiliation":[{"name":"Translational Public Health and Evaluation Division, Stroke and Ageing Research, Department of Medicine (D.A.C., T.P.), School of Clinical Sciences at Monash Health, Monash University, Clayton, 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Research, Department of Medicine (D.A.C., T.P.), School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8159-9817","authenticated-orcid":true,"given":"Shabnam","family":"Jalili-Moghaddam","sequence":"additional","affiliation":[{"name":"National Institute of Stroke and Applied Neurosciences, Auckland University of Technology, New Zealand (V.L.F., S.J.-M., R.V.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-6216","authenticated-orcid":true,"given":"Gemma","family":"Kitsos","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (S.L.G., K.C., M.R.N., G.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0869-2083","authenticated-orcid":true,"given":"Rita 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