Co-Designed Digital Education and Peer Support for Young and Middle-Aged Stroke Survivors

Stroke survivors often experience persistent unmet needs during long-term recovery. Young and middle-aged stroke survivors may face additional challenges in balancing rehabilitation with work and family responsibilities. Although digital health interventions have the potential to improve access to education and self-management support, existing programs are often provider-driven, provide limited peer support, and have short follow-up periods. This study aims to evaluate the effectiveness of a patient-centered digital education and peer support intervention co-designed with young and middle-aged stroke survivors. Participants will be randomly assigned to either the intervention group or the usual care group. The intervention will be delivered through LINE communities and Google collaborative platforms over a 12-month period. The primary outcome is unmet needs. Secondary outcomes include stroke self-efficacy, depressive symptoms, quality of life, activities of daily living, instrumental activities of daily living, and return-to-work status.

Inclusion Criteria: * Aged 31 to 64 years. * Diagnosis of stroke confirmed by computed tomography (CT) or magnetic resonance imaging (MRI) and physician diagnosis. * Received treatment at the Stroke Center of Linkou Chang Gung Memorial Hospital. * Conscious and able to communicate, including individuals with mild aphasia. * Willing and able to provide informed consent. Exclusion Criteria: * End-stage cancer. * Severe aphasia resulting in inability to communicate. * Dependent in basic activities of daily living before the index stroke (Barthel Index \