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Although mealtime group activities are commonly used in rehabilitation settings to support recovery, these approaches are rarely standardised, systematically developed, or evidence-informed, and there is limited research evaluating structured group-based mealtime interventions in stroke care. Co-produced, contextually grounded interventions may improve engagement and clinical relevance. This study aimed to co-design a breakfast group intervention to address eating and drinking difficulties for people after stroke in hospital settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This intervention development study was conducted across three secondary care hospital stroke wards. Ten online workshops were held with a 15-member Stakeholder Intervention Development Group comprising stroke survivors, informal carers, and multidisciplinary healthcare professionals. An iterative co-design process was used, informed by prior systematic review findings, observational work, interviews, and trigger films exploring lived experiences. Intervention development combined Hawkins\u2019 framework with Experience-Based Co-Design. Workshops involved structured co-design activities, group discussion, and reflection on personal experiences. Data from workshops were synthesised collaboratively to refine intervention content and delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Stakeholders co-produced the Breakfast Group Intervention for Stroke Rehabilitation (BISTRo) and an accompanying implementation toolkit. Five core components were identified: (1) multidisciplinary participation, (2) physical rehabilitation, (3) food preparation and choice, (4) peer support, and (5) psychological well-being. The intervention was tailored for delivery on hospital stroke wards, with adaptations for infection control procedures and local contextual variation. Online participatory methods enabled sustained engagement and inclusive contribution from diverse stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using Experience-Based Co-Design within Hawkins\u2019 framework supported the inclusive and iterative development of a complex rehabilitation intervention. This co-produced approach generated a contextually grounded breakfast group model suitable for feasibility testing and future evaluation. The findings highlight the value of stakeholder partnership in designing health service interventions addressing post-stroke eating and drinking difficulties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The study was registered on Clinical Trials.gov ID NCT05102812 on the 17th of February 2022.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-026-14977-2","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T06:39:09Z","timestamp":1782196749000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Developing a rehabilitation intervention for eating and drinking difficulties following stroke through co-design stakeholder workshops"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6177-1808","authenticated-orcid":false,"given":"Natalie","family":"Jones","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2795-8983","authenticated-orcid":false,"given":"Susan","family":"Mawson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1220-8354","authenticated-orcid":false,"given":"Avril","family":"Drummond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily","family":"Booth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polly","family":"Sedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Horner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marge","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4033-506X","authenticated-orcid":false,"given":"Alicia","family":"O\u2019Cathain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"14977_CR1","doi-asserted-by":"publisher","unstructured":"Song W, Wu M, Wang H, Pang R, Zhu L. 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Ethical approval was obtained from the appropriate NHS Ethics Board. Approval for the study was granted by the North West- Haydock NHS Research Ethics Committee on 5 January 2021 (REC 21\/NW\/0313). The study was registered on ClinicalTrials.gov, ID: NCT05102812 on 17\/02\/222. All participants received written information about the study and provided written informed consent before participation. As part of the approved NHS ethics protocol, participants received detailed information about the potential use of images, video recordings, and study artefacts in publications. All patient and public participants provided written consent permitting the use of these materials in research outputs, including academic publications.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent for publication of identifiable images and video material was obtained from participants where applicable. No identifiable content was included in publications or dissemination materials without explicit permission. Separate explicit consent was obtained from participants for the recording of trigger videos, the use of still photographs taken during the site prototype testing, and the inclusion of these media in conference presentations, teaching, dissemination events, and supplementary research outputs such as publications. Participants who did not wish to be photographed were able to keep cameras off, sit outside the camera field, or contribute verbally without their image being captured. All identifiable photographs and video content included in publications or dissemination material were used only where participants had given specific permission.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1248"}}