Objective Unhealthy lifestyle is common among patients with ischemic stroke or TIA. Hence, health‐related behavior change may be an effective way to reduce stroke recurrence. However, this is often difficult to carry out successfully. We aimed to explore patients' perspectives on health‐related behavior change, support in this change, and sustain healthy behavior. Methods We conducted a descriptive qualitative study with in‐depth, semistructured interviews in eighteen patients with recent TIA or ischemic stroke. Interviews addressed barriers, facilitators, knowledge, and support of health‐related behavior change framed by the protection motivation theory. All interviews were transcribed and thematically analyzed. Results Patients seem unable to adequately appraise their own health‐related behavior. More than half of the patients were satisfied with their lifestyle and felt no urgency to change. Self‐efficacy as coping factor was the most important determinant (both barrier and facilitator). Fear as threat factor was named as facilitator for health‐related behavior change by half of the patients. Most of the patients did not need support or already received support in changing health behavior. Patients indicated knowledge, guidelines, and social support as most needed to support and preserve a healthy lifestyle. Conclusion This study suggests that patients with recent TIA or ischemic stroke often do not have a high intention to change health‐related behavior. The results fit well within the framework of the protection motivation theory. As many patients seem unable to adequately appraise their health behaviors, interventions should focus on increasing knowledge of healthy behavior and improving self‐efficacy and social support.

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