{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:10:24Z","timestamp":1790752224046,"version":"4.1.0"},"reference-count":52,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Cardio"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Regular physical activity is critical for preventing secondary stroke following a stroke or transient ischemic attack (TIA). Although mobile health (mHealth) interventions have shown promise for promoting short-term increases in physical activity, evidence on their long-term effects and the mechanisms that support sustained behavior change remains limited. In particular, little is known about how people poststroke or TIA integrate the skills, knowledge, and habits gained through mHealth interventions into their daily lives once structured intervention support ends.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to explore the perceived barriers and facilitators of maintaining physical activity among individuals poststroke or TIA after completing an mHealth intervention.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A qualitative approach was used, involving a strategic sample of 12 participants recruited after they had completed a 6-month mHealth intervention for people poststroke or TIA. The intervention included supervised physical therapy with mHealth support for physical exercises and behavior change (eg, counseling, goal-setting, and self-monitoring), followed by a 6-month postintervention period with access to self-managed mHealth support. To enable richness and depth in participants\u2019 accounts, the dataset consisted of 2 semistructured interviews conducted 3 months and 6 months after completing the intervention, along with participant-generated photographs. Between the interviews, participants took photos to reflect their experiences of maintaining physical activity after the intervention. These images served as prompts for dialog and reflection during the second interview. Data were analyzed using reflexive thematic analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We generated 3 themes: building experience and knowledge to maintain physical activity, staying physically active in a complex life situation, and the meaning of context for maintaining physical activity after the intervention. Barriers and facilitators were conceptually integrated into a comprehensive understanding of maintaining physical activity, symbolized by the metaphor of a soap bubble, which requires persistence and a supportive environment to stay afloat. The complexity of participants\u2019 health and life situations created barriers to maintaining physical activity. To overcome these barriers, developing personal strategies within a supportive social and physical context was crucial. This development was facilitated by the mHealth intervention, which enabled knowledge acquisition of the principles of physical activity after stroke or TIA, along with increased awareness of its health benefits.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n mHealth interventions for people poststroke and TIA can serve as a catalyst for physical activity engagement and an enhancer of the knowledge and experience necessary to maintain physical activity after the intervention. Despite health-related and contextual barriers, participants may use personalized strategies, supported by their social and environmental context, to navigate these challenges. These insights highlight opportunities for future mHealth interventions to strengthen the interaction between individuals and their environment and empower tailored strategies for behavior change and long-term physical activity maintenance.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/87493","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T19:51:55Z","timestamp":1779911515000},"page":"e87493-e87493","source":"Crossref","is-referenced-by-count":1,"title":["Barriers and Facilitators to Maintaining Physical Activity After an mHealth Intervention for People Poststroke or Transient Ischemic Attack: Reflexive Thematic Analysis"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9179-8558","authenticated-orcid":false,"given":"Hanna","family":"Lagerlund","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0003-5513","authenticated-orcid":false,"given":"David","family":"Moulaee Conradsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0366-4609","authenticated-orcid":false,"given":"Charlotte K","family":"H\u00e4ger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3117-6765","authenticated-orcid":false,"given":"Lydia","family":"Kwak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8321-0174","authenticated-orcid":false,"given":"Lisa","family":"Holmlund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"issue":"10","key":"R1","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"20","author":"Feigin","journal-title":"Lancet Neurol"},{"issue":"2","key":"R2","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/S1474-4422(13)70255-2","article-title":"Secondary stroke prevention","volume":"13","author":"Hankey","journal-title":"Lancet Neurol"},{"issue":"5","key":"R3","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.12.029","article-title":"Cardiorespiratory fitness after transient ischemic attack and minor ischemic stroke: baseline data of the MoveIT study","volume":"26","author":"Boss","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"2","key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.arrct.2025.100457","article-title":"A systematic scoping review of poststroke engagement in physical activity","volume":"7","author":"Pasztor","journal-title":"Arch Rehabil Res Clin Transl"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/08964289.2020.1750335","article-title":"What happens when the party is over?: Sustaining physical activity behaviors after intervention cessation","volume":"48","author":"McEwan","journal-title":"Behav Med"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","DOI":"10.2196\/26699","article-title":"Long-term effectiveness of mHealth physical activity interventions: systematic review and meta-analysis of randomized controlled trials","volume":"23","author":"M\u00f6nninghoff","journal-title":"J Med Internet Res"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1111\/nuf.12296","article-title":"How is exercise different from physical activity? 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