Dorien Brouwer

76 Chapter 1.4 PART 1 ABSTRACT Objective: The optimal timing of an intervention to support health-related behavior after TIA or ischemic stroke is unknown. As the determinants of intention to change health- related behavior probably vary over time, there may be a window of opportunity to start a health-related behavior supporting intervention. We aimed to assess determinants of patients’ health-related intention to change over time. Methods : We prospectively studied 100 patients with TIA or minor ischemic stroke. Patients completed questionnaires on fear, response-efficacy (believe that lifestyle change reduces risk of recurrent stroke), and self-efficacy (patients’ confidence to carry out lifestyle behavior) for behavior change, at baseline, six weeks and at 3 months after their TIA or ischemic stroke. We studied differences between these determinants at each visit by means of Wilcoxon signed rank tests. Results: Median self-efficacy score at baseline was 4.3 (IQR 3.9-4.7), median fear 16 (IQR 7-21), and response efficacy 10 (9-12). Fear was significantly higher at baseline than at 3 months (mean difference 2.0; 95% CI 0.78-3.9) and started to decrease after six weeks. No change in self-efficacy or response efficacy was found. Conclusion: Since fear significantly decreased over time after TIA or ischemic stroke and self-efficacy and response efficacy scores remained high, the optimal moment to start an intervention to support patients in health-related behavior change after TIA or ischemic stroke seems directly after the stroke or TIA. Submitted