The hand activity and behavior intervention (HABIT): a novel group to increase daily hand-use post-stroke

To describe the development of The Hand Activity and Behavior Intervention (HABIT) and to evaluate its feasibility and initial effectiveness in increasing daily hand‑use among individuals post‑stroke with good motor ability. HABIT was developed by integrating behavior‑change principles, a motivational-social theory and an occupational therapy model. Community‑dwelling adults post‑stroke (Fugl–Meyer Assessment ≥ 43/66) participated in HABIT (10-group sessions). Session attendance and satisfaction measured feasibility. Effectiveness was assessed at baseline (PRE1), pre‑intervention (PRE2), post‑intervention (POST1), and follow‑up (POST2) using The Canadian Occupational Performance Measure (COPM) (performance and satisfaction for participant-selected goals using the affected upper extremity), the Rating of Everyday Arm‑Use in the Community and Home (REACH) (daily hand-use), Confidence in Arm and Hand Movement scale (CAHM), and the Dual Overload Interference Test (DO‑IT). Trial registration: NCT06455241. Eleven adults post‑stroke participated in HABIT. Attendance and satisfaction were high. No changes between PRE1–PRE2. Median (IQR) COPM performance increased from 4.0 (2.2–4.8)-PRE2 to 7.3 (5.1–8.1)-POST1 and 7.0 (5.7–7.7)-POST2 (z = −2.85, pp HABIT is feasible and demonstrates preliminary effectiveness in improving daily hand-use among individuals with good motor ability post-stroke. Individuals post-stroke with good motor ability may still show limited daily hand-use, highlighting the need for targeted behavioral interventions.The Hand Activity and Behavior Intervention (HABIT), a structured group-based intervention, is feasible and acceptable, with high attendance and satisfaction.Meaningful improvements were achieved in daily hand-use without changes in motor function.Group delivery fosters peer support and motivation, contributing to sustained real-world hand-use. Individuals post-stroke with good motor ability may still show limited daily hand-use, highlighting the need for targeted behavioral interventions. The Hand Activity and Behavior Intervention (HABIT), a structured group-based intervention, is feasible and acceptable, with high attendance and satisfaction. Meaningful improvements were achieved in daily hand-use without changes in motor function. Group delivery fosters peer support and motivation, contributing to sustained real-world hand-use.