Nurse-Led Instant Message-Delivered Dyadic Intervention in Sodium Intake Reduction Knowledge, Attitude and Practice in Hypertensive Stroke Survivors: Randomised Controlled Trial Protocol.

AIMS: To evaluate the effectiveness of a nurse-led, instant message-delivered dyadic behavioural intervention on sodium intake reduction knowledge, attitude and practice (KAP) among stroke survivors with hypertension (HTN).

DESIGN

A single-blind, two-arm parallel randomised controlled trial.

METHODS

A total of 110 stroke survivor-family caregiver dyads will be randomised. Dyads in the intervention group will receive 60 brief regular messages about sodium intake reduction education and practical skills, plus nurse-led real-time chat support via an instant messaging application (i.e., WeChat) for 2 months, while the control group will receive 10 brief regular messages about stroke education only. The primary outcome is stroke survivors' sodium intake reduction KAP immediately post-intervention (T1). Secondary outcomes include stroke survivors' KAP at 2-month follow-up (T2), blood pressure (BP), self-efficacy, quality of life and dyadic relationship (DR) at T1 and T2; family caregivers' sodium intake reduction KAP, self-efficacy, DR and caregiver burden at T1 and T2. Following intention-to-treat, the effects will be analysed using generalised estimating equations adjusting for covariates.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study provides nurses with a replicable model for designing theory-driven, behaviour change technique-incorporated interventions targeting sodium intake reduction. Evidence on changes in KAP and BP among stroke survivors with HTN will inform nurse-led secondary stroke prevention strategies.

IMPACT: By leveraging nurses and a widely accessible instant messaging platform, this study will demonstrate a scalable mobile health approach to address the leading dietary risk factor for stroke burden in China, potentially applicable to similar settings where sodium intake is amenable to behavioural interventions and contributing to the World Health Organization's global sodium reduction target.

REPORTING METHOD: SPIRIT 2013 Statement.

PATIENT OR PUBLIC CONTRIBUTION: Health professionals, stroke survivors and family caregivers were invited to evaluate the intervention development.

TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2400086708.