Background: It is of great signi cance for brain and heart health managers to assess the electronic health literacy of people at high risk of stroke for improving the current situation of stroke in China. Although various measuring instruments have been developed, there is still a lack of suitable tools to match the development of network.Aim: To examine the reliability and validity of the electronic Health Literacy Scale e-HLS among people at high risk of stroke in China, so as to provide appropriate measurement tools for brain heart health managers.Methods: A demographic questionnaire, the electronic Health Literacy Scale e-HLS and the eHealth Literacy Scale (eHEALS) were administered to a sample of 648 people at high risk of stroke recruited from November to December 2020 in a tertiary hospital.Results: The Cronbach'α coe cient on the e-HLS-CHI was 0.91. Three factors were extracted by Exploratory Factor Analysis (EFA), accounting for 90.84% of the total variance. Con rmatory Factory Analysis (CFA) revealed that three factors of e-HLS-CHI t well ( NFI = 0.979, RFI = 0.955, IFI = 0.987, TLI = 0.972, CFI=0.987, RMSEA = 0.070, CMIN/DF= 2.586). Good simultaneous validity was suggested by the positive correlation of 0.94 between the e-HLS-CHI and eHEALS. And when using eHEALS as the standard, the area under the ROC curve of e-HLS-CHI was 0.896 (95% CI: 0.831-0.960, P = 0.000). After calculation, the sensitivity and speci city were 97.8% and 70.4% respectively, indicating that it has nice predictive validity.Conclusions: The e-HLS can be used to evaluate electronic health literacy of people at high risk of stroke in China. This may be helpful for brain and heart health managers to assess the current situation of electronic health literacy in people at high risk of stroke and provide reference for future health promotion programs.

Purpose: To examine the effectiveness of goal-based health management on health knowledge, health belief and health behavior in people at high risk of stroke. Patients and Methods: This is a two-armed and non-randomized controlled trial from May 31, 2020 to December 31, 2020. Participants were arranged to receive regular health care (n=126) or goal-based health management (n=126). The generalized estimation equation was used to analyze the changes in the participants' health knowledge, health belief and health behavior at baseline (T0), 1-month (T1), 3-month (T3), and 6-month (T6). Results: A total of 243 participants completed the 6-month study, of which 123 were in the control group and 120 were in the intervention group. After receiving goal-based health management, participants' health behavior (β=27.154, p<0.001), health knowledge (β=10.504, p<0.001) and health belief (β=49.057, p<0.001) scores increased significantly. Conclusion:Goal-based health management can effectively improve the health knowledge, health belief and health behavior of people at high risk of stroke. We recommend that nurses can provide goal-based health management for people at high risk of stroke with support from hospitals and family members of people at high risk of stroke.

Background Effective health management of people at high risk of stroke in China is challenging. Aim To explore and identify the experiences of health management among people at high risk of stroke in order to provide a foundation for a targeted health management strategy for this special group. Design A qualitative, descriptive study based on interviews. Methods Semistructured interviews were conducted with 31 people at high risk of stroke. The interviews were collated and analysed using Colaizzi’s seven‐step method. Results A total of 31 people at high risk of stroke were included, and the ages ranged from 40 to 86, with an average age of 60.71 (SD = 11.55). The experiences of health management were categorized into three themes. Theme 1: Facing many ongoing problems in health management, limited knowledge, lack of confidence and poor compliance. Theme 2: Accumulated some value experiences of coping with problems of health management, becoming active learners, promoting social interaction and enhancing self‐health management. Theme 3: Sensitivity to multiple influencing factors, the severity of disease and complexity of disease management, family income and economic burden and the value of social support. Conclusions This study explored the experiences of health management among people at high risk of stroke, and these findings are of great significance in the primary prevention of stroke.

BACKGROUND Effective health management of people at high risk of stroke is challenging. OBJECTIVE To identify and explore the experiences of health management among people at high risk of stroke in order to inform ideas for health management service development for this population. METHODS Semi-structured interviews were conducted with 31stroke people at high risk of stroke. The interviews were collated and analyzed using Colaizzi’s 7-step method. RESULTS The experiences of health management in people at high risk of stroke were described as ‘Survival in the gap’. Themes identified limited knowledge of health management, lack of confidence in health management and poor adherence with health management. The value of health management experience was highlighted and included: becoming active learners, promoting social interaction and enhancing self-health management. Health management was seen to be sensitive to multiple influencing factors including: The severity and complexity of diseases, family income and social support. CONCLUSIONS Health management of people at high risk of stroke is challenging and they ‘survive in the gap’. They learn to manage their ongoing health based mainly on their own experiences. Government and healthcare providers should pay attention to the situation for this special population and be devoted to health system reform, financial support and social support to manage the condition in the longer term.