The Targeted Management (TEAM) Intervention for Reducing Stroke Risk in African American Men: Rationale and Study Design of a Prospective Randomized Controlled Trial.
The Targeted Management (TEAM) Intervention for Reducing Stroke Risk in African American Men: Rationale and Study Design of a Prospective Randomized Controlled Trial.
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DOI：
10.2147/jmdh.s288753
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发表时间：
2021
影响因子：
3.3
通讯作者：
Sajatovic M
中科院分区：
文献类型：
--
作者：
Still CH;Burant C;Moore S;Einstadter D;Killion C;Modlin C;Sundararajan S;Thornton JD;Wright JT Jr;Sajatovic M
非裔美国人（AA）中风或短暂性脑缺血发作（TIA）的男性幸存者与其他种族相比，中风复发的风险最高。然而，缺乏循证策略，包括组织、教育或行为干预，以降低AA男性继发性卒中风险。降低卒中风险的目标管理（TEAM）是一项正在进行的为期6个月的前瞻性随机对照试验，将确定使用同伴配对（患有卒中或TIA的男性及其护理伴侣）的健康指导自我管理方法是否会改善AA男性的卒中后护理。研究样本将包括160名在5年内经历过卒中或TIA的AA男性，随机分配至TEAM或等待名单对照组。主要结果是收缩压（BP）和高密度脂蛋白（HDL）的变化，而次要结果包括舒张压，总胆固醇，低密度脂蛋白，甘油三酯和糖尿病患者的血糖控制。我们假设，在6个月时，与等待名单对照组中的AA男性相比，TEAM中的AA男性的收缩压显著降低，HDL显著升高。AA男性中风负担的持续差异突出了新的干预措施，以促进继发性中风风险降低的必要性。建立在有前途的试点数据，团队使用一组格式，与护士和病人共同主导的干预重点是AA男性和家庭的需求，在解决问题的做法，并注意情绪和角色管理。此外，TEAM方法可能有助于减少AA男性的中风风险因素和健康差异。NCT 04402125。
African American (AA) male survivors of strokes or transient ischemic attacks (TIA) have the highest risk of recurrent stroke when compared to other racial-ethnic men. However, there is a paucity of evidence-based strategies, including organizational, educational, or behavioral interventions, that targets secondary stroke risk reduction in AA men. Targeted Management for Reducing Stroke Risk (TEAM) is an ongoing, 6-month prospective, randomized controlled trial that will determine whether a curriculum-guided self-management approach, using peer dyads (men who had a stroke or TIA and their care partners) will improve post-stroke care in AA men. The study sample will consist of 160 AA men who have experienced a stroke or TIA within 5 years, randomized to TEAM or Wait-list control group. The primary outcome changes in systolic blood pressure (BP) and high-density lipoprotein (HDL), while secondary outcomes include diastolic BP, total cholesterol, low-density lipoprotein, triglycerides, and glycemic control for diabetics. We hypothesize that AA men in TEAM will have significantly lower systolic BP and higher HDL when compared to AA men in the Wait-list control group at 6-month. Persistent disparities for stroke burden in AA men highlight the need for novel interventions to promote secondary stroke-risk reduction. Building on promising pilot data, TEAM uses a group format, with a nurse and patient co-led intervention focused on AA men and family needs, practice in problem-solving, and attention to emotional and role management. In addition, the TEAM approach may help reduce stroke risk factors and health disparities in AA men. NCT04402125.