We sought to understand influences on PA from stroke patients who reside in an urban underserved community

Participants included 57% Black, 29% Hispanic and 50% women with mean age 58.9 (±9.6) yrs. A third had ≤ high school education, and 43% had Medicaid or no insurance. PROMIS-PF mean score was less than average at 44.6 (10.1) but 46% self-reported high PA levels in the IPAQ. We identified three key themes as influencing PA: 1. Positive outcome expectations for PA, either affective, social or physical, 2. Self-efficacy: confidence to navigate socio-structural barriers, and 3. Agency: being in charge of own actions, out of necessity or by choice. While all participants identified PA with recovery, there was limited knowledge of recommended goals and target levels. Psychological needs of autonomy were tied to environmental barriers specific to urban living such as navigating stairs, or neighborhood crime risk. Low balance confidence was the most stated barrier to PA participation in the community, with two-thirds reporting fear of falling after returning home.