Introduction: Evidence suggests that sedentary behaviour has detrimental effects on health and well-being.  Stroke survivors are particularly sedentary compared to age-matched controls and at risk of associated negative effects including reduced physical function, increased mood problems and mortality. This NIHR(UK)-funded programme aims to develop and evaluate a complex intervention to reduce/break up sedentary behaviour after stroke.
Methods: The programme comprises five work-streams (WS).  WS1 will update quantitative and qualitative evidence relating to sedentary behaviour through systematic reviews.  WS2 is a qualitative study involving observations in two stroke services and interviews with patients, carers and staff, to explore sedentary behaviours and participants’ capability, opportunity and motivation to address them.  WS3 will develop an intervention using co-production principles; WS4 will explore the feasibility of its implementation using a case-study and action research approach.  Finally, WS5 will evaluate clinical and cost-effectiveness using a multicentre cluster Randomised Controlled Trial in 34 stroke services with embedded process evaluation.  
Results: The primary outcome will be health and disability (WHO Disability Assessment Schedule) at 12 months after recruitment (N=1156).  Outcomes will be assessed at baseline, 6, 12 and 24 months and include sedentary behaviour, mood, quality of life, vascular events, CVD risk factors, death and health/social care service use. 
Conclusion: The research will generate an internationally-leading dataset on patterns of sedentary behaviour after stroke, with linked health outcomes, and robustly evaluate a comprehensive intervention protocol. A successful intervention has potential to substantially impact functioning, health and well-being outcomes for stroke survivors at relatively low cost.

The REduCing sedentaRy bEhaviour After sTrokE Study (RECREATE): Development and evaluation of an intervention to improve outcomes