Tailored personas for home-based fall prevention among older adults with stroke: A qualitative study

Abstract Background and Objectives Existing home-based fall prevention strategies often adopt a one-size-fits-all approach despite substantial heterogeneity among older adults with stroke. Persona-based methods may facilitate more individualized intervention design, yet remain largely unexplored in stroke rehabilitation. This study explored variations in fall prevention self-management among older adults with stroke and developed user personas to represent their diverse experiences, challenges, and support needs. Research Design and Methods A qualitative descriptive study was conducted among 26 older adults with stroke receiving home-based care in China. Participants were recruited using purposive maximum-variation sampling. Semi-structured interviews were conducted between January and March 2026. Data were analyzed using qualitative content analysis to identify key dimensions of fall prevention self-management. Individual participant profiles were iteratively synthesized through cross-case comparison into composite personas representing recurring configurations of behaviors, beliefs, barriers, resources, and support needs. Results Five distinct personas emerged: proactive self-managers, risk-discounting managers, routine-based managers, support-constrained managers, and professionally supported managers. These personas demonstrated distinct combinations of fall-risk perception, social resources, environmental constraints, and healthcare dependence. Discussion and Implications The findings demonstrate substantial diversity in how older adults with stroke manage fall prevention in home settings. Persona-based stratification provides an actionable approach for designing scalable, context-sensitive fall prevention interventions.