Tailored Personas For Home-based Fall Prevention Among Older Adults With Stroke: A Qualitative Study

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.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.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.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.