# Mobile Health Application for the Prevention of Stroke (MAPS): a pilot, single-arm study on an innovative health application designed for primary stroke prevention

## TL;DR

The MAPS app helped improve daily health habits and reduce stroke risk factors in a pilot study of 35 adults over 6 months.

## Contribution

The study introduces and evaluates the MAPS app, a mobile health tool for primary stroke prevention through habit improvement.

## Key findings

- Significant improvements in daily health habits were observed after 6 months of using the MAPS app.
- Estimated 5-year stroke risk, BMI, and abdominal circumference decreased significantly.
- Male participants showed greater improvement in dietary health choices.

## Abstract

Long-term changes in healthy behavior are more likely when small improvements are made in daily health habits. Health applications can serve as cost-effective tools to help people adopt healthier lifestyles. In response to this need, we developed the MAPS app - an easy-to-use and innovative mobile health app for the primary prevention of stroke.

We conducted a prospective, pre-post, single-arm, multicomponent interventional pilot study over 6 months to evaluate the ability of the MAPS app to enhance healthy habits and reduce stroke risk factors among a healthy adult population recruited from an urban employer in Germany. Daily health habits were assessed using questionnaires at the beginning of the study, at 3 months, and at 6 months. We also measured estimated stroke risk over 5 and 10 years, as well as systolic blood pressure, Body Mass Index (BMI), abdominal circumference, LDL cholesterol, and HbA1c levels at the beginning and after 6 months.

A total of 35 participants were recruited. One participant was lost to follow-up. Our analysis showed significant improvements in the daily health habits questionnaire after 6 months (mean change of 5.6 points; 95% confidence interval (CI) 3.20 to 7.95). We observed significant reductions in the estimated 5-year stroke risk (mean change − 0.3%; 95% CI -0.52 to -0.04), BMI (mean change − 0.6 kg/m²; 95% CI -1.17 to -0.02), and abdominal circumference (mean change − 2.8 cm; 95% CI -5.28 to -0.25). Changes in LDL cholesterol and HbA1c levels were not significant. Male participants tended to have lower initial scores on daily habit questionnaires, particularly in dietary health choices, and benefited more from participation in the study.

Our results suggest that the MAPS app may help promote healthier daily habits and reduce stroke risk. While promising, these preliminary findings require further validation through larger randomized controlled trials. Additionally, they indicate potential gender-specific responses that need more investigation.

The study was registered retrospectively in the German Clinical Trials Register on 25th November 2024. (DRKSID DRKS00034491). Trial registration was submitted before enrollment started, but it was finalized after recruitment began due to technical issues.

The online version contains supplementary material available at 10.1186/s12883-025-04560-3.