Lifestyle interventions to reduce second stroke risk are complex. For effective translation into practice, interventions must be specific to end-user needs and described in detail for replication. This study used an Integrated Knowledge Translation (IKT) approach and the Template for Intervention Description and Replication (TIDieR) checklist to co-design and describe a telehealth-delivered diet program for stroke survivors. Stroke survivors and carers (n = 6), specialist dietitians (n = 6) and an IKT research team (n = 8) participated in a 4-phase co-design process. Phase 1: the IKT team developed the research questions, and identified essential program elements and workshop strategies for effective co-design. Phase 2: Participant co-design workshops used persona and journey mapping to create user profiles to identify barriers and essential program elements. Phase 3: The IKT team mapped Phase 2 data to the TIDieR checklist and developed the intervention prototype. Phase 4: Co-design workshops were conducted to refine the prototype for trial. Rigorous IKT co-design fundamentally influenced intervention development. Modifications to the protocol based on participant input included ensuring that all resources were accessible to people with aphasia, an additional support framework and resources specific to outcome of stroke. The feasibility and safety of this intervention is currently being pilot tested (randomised controlled trial; 2019/ETH11533, ACTRN12620000189921).

The Mediterranean diet pattern (MEDI) is associated with a lower risk of chronic conditions related to ageing. Adherence research mostly comes from Mediterranean countries with high cultural acceptability. This study examines the feasibility of a MEDI intervention designed specifically for older Australians (AusMed). Phase 1 involved a consumer research group (n = 17) presentation of program materials with surveys after each section. In-depth individual semi-structured interviews (n = 6) were then conducted. All participants reported increased knowledge and confidence in adherence to the MEDI, with the majority preferring a booklet format (70%) and group delivery (58%). Three themes emerged from interviews—1. barriers (complexity, perceived cost and food preferences), 2. additional support and 3. individualisation of materials. Program materials were modified accordingly. Phase 2 was a 2-week trial of the modified program (n = 15). Participants received a group counselling session, program manual and food hamper. Adherence to the MEDI was measured by the Mediterranean Diet Score (MDS). All participants increased their adherence after the 2-week trial, from a mean score of 5.4 ± 2.4 (low adherence) to a mean score of 9.6 ± 2.0 (moderate to high adherence). All found that text message support helped achieve their goals and were confident to continue the dietary change.

<b><i>Background:</i></b> Increasing physical activity (PA) and improving diet quality are opportunities to improve secondary stroke prevention, but access to appropriate services is limited. Interventions co-designed with stroke survivors and delivered by telehealth are a potential solution. <b><i>Aim:</i></b> The aim of this study is to test the feasibility, safety, and potential efficacy of a 6-month, telehealth-delivered PA and/or dietary (DIET) intervention. <b><i>Methods:</i></b> Pilot randomized trial. 80 adults with previous stroke who are living at home with Internet access and able to exercise will be randomized in a 2 × 2 factorial (4-arm) pilot randomized, open-label, blinded outcome assessment trial to receive PA, DIET, PA + DIET, or control interventions via telehealth. The PA intervention aims to support participants to meet the minimum recommended levels of PA (150 min/week moderate exercise), and the DIET intervention aims to support participants to follow the AusMed (Mediterranean-style) diet. The control group receives usual care plus education about PA and healthy eating. The co-primary outcomes are feasibility (proportion and characteristics of eligible participants enrolled and proportion of scheduled intervention sessions attended) and safety (adverse events) at 6 months. The secondary outcomes include recurrent stroke risk factors (blood pressure, physical activity levels, and diet quality), fatigue, mood, and quality of life. Outcomes are measured at 3, 6, and 12 months. <b><i>Conclusion:</i></b> This trial will produce evidence for the feasibility, safety, and potential effect of telehealth-delivered PA and DIET interventions for people with stroke. Results will inform development of an appropriately powered trial to test effectiveness to reduce major risk factors for recurrent stroke. <b><i>Trial registration:</i></b> ACTRN12620000189921.

Convincing evidence exists for the positive effect of an improvement in diet quality on age-related cognitive decline, in part due to dietary fatty acid intake. A cross-sectional analysis of data from the Hunter Community Study (HCS) (n = 2750) was conducted comparing dietary data from a validated Food Frequency Questionnaire (FFQ) with validated cognitive performance measures, Audio Recorded Cognitive Screen (ARCS) and Mini Mental State Examination (MMSE). Adjusted linear regression analysis found statistically significant associations between dietary intake of total n-6 fatty acids (FA), but no other FAs, and better cognitive performance as measured by the ARCS (RC = 0.0043; p = 0.0004; R2 = 0.0084). Multivariate regression analyses of n-6 FA intakes in quartiles showed that, compared with the lowest quartile (179.8–1150.3 mg), those in the highest quartile (2315.0–7449.4 mg) had a total ARCS score 2.1 units greater (RC = 10.60466; p = 0.006; R2 = 0.0081). Furthermore, when n-6 FA intake was tested against each of the ARCS domains, statistically significant associations were observed for the Fluency (RC = 0.0011432; p = 0.007; R2 = 0.0057), Visual (RC = 0.0009889; p = 0.034; R2 = 0.0050), Language (RC = 0.0010651; p = 0.047; R2 = 0.0068) and Attention (RC = 0.0011605; p = 0.017; R2 = 0.0099) domains, yet there was no association with Memory (RC = −0.000064; p = 0.889; R2 = 0.0083). No statistically significant associations were observed between FA intakes and MMSE. A higher intake of total n-6 FA, but not other types of FA, was associated with better cognitive performance among a representative sample of older aged Australian adults.