Recurrent stroke significantly contributes to the global burden of stroke. Stroke secondary prevention, which promotes healthy lifestyle behaviors, is seen as a priority solution to reduce this burden. However, many post-stroke individuals maintain unhealthy lifestyles, often citing a lack of stroke education as a barrier to adopting healthier habits. Understanding whether knowledge about stroke influences the adoption of healthy behaviors can help guide secondary prevention strategies, where health education plays a crucial role in empowering individuals to make informed lifestyle choices.

This study aimed to assess whether knowledge about stroke—its definition, signs, symptoms, risk factors, and the individual’s belief in the possibility of another stroke —predicts the adoption of healthy lifestyle behaviors during the chronic phase post-stroke.

A cross-sectional study was conducted through telephone interviews with individuals in the chronic post-stroke phase, collecting data on sociodemographic, lifestyle behaviors, and stroke-related knowledge. Descriptive statistics and binary logistic regression (a = 5%) were used for analysis. The dependent variables were smoking cessation, safe alcohol consumption, healthy diet, physical activity, and the simultaneous adoption of all four healthy behaviors. Predictor variables related to stroke knowledge included knowing what a stroke is, its signs, symptoms, risk factors, and belief in the risk of a new stroke.

Seventy-five individuals participated (mean age: 63 ± 13 years; 50% male). Of them, 65 (87%) did not smoke, 74 (89%) consumed alcohol safely, 48 (64%) ate at least two servings of fruits/vegetables daily, 25 (33%) engaged in = 1 hour of physical activity weekly, and 14 (19%) adopted all four healthy behaviors. Regarding stroke knowledge, 43 (57%) knew what a stroke is, 41 (55%) knew its signs and symptoms, 29 (39%) knew its risk factors, and 33 (44%) believed they were at risk of a new stroke. Knowledge of stroke risk factors was found to significantly predict physical activity participation (B: 1.08, OR: 2.95, 95% CI: 1.03-8.41, p = 0.043) and the simultaneous adoption of all healthy behaviors (B: 1.45, OR: 4.27, 95% CI: 1.15-15.82, p = 0.030).

Knowledge of stroke risk factors significantly predicted physical activity participation and the combined adoption of smoking cessation, safe alcohol consumption, a healthy diet, and post-stroke physical activity. Screening for knowledge of stroke risk factors could help identify individuals who need targeted secondary prevention education. Health education on this topic is essential in promoting the adoption of healthy lifestyle behaviors for stroke secondary prevention.

This study highlights the importance of health education in secondary stroke prevention, particularly in addressing knowledge about stroke risk factors to encourage healthy lifestyle behaviors. It also underscores the need for screening knowledge on stroke risk factors to identify individuals who require targeted education. These findings are relevant for healthcare professionals involved in secondary stroke prevention and suggest that future studies should explore whether providing knowledge about stroke risk factors can promote healthier behaviors and reduce recurrence rates.