HISPANIC SECONDARY STROKE PREVENTION INITIATIVE

描述（由申请人提供）：中风是美国成年人残疾的主要可预防原因。中风对西班牙裔人口的影响也不成比例，他们的快速增长和老龄化将导致中风对公共卫生的影响在未来急剧增加。在西班牙二级卒中预防倡议中，我们提出了一个旨在降低卒中复发风险的转化研究项目。我们的重点是中风患者，因为他们在未来五年内复发的风险超过25%，而且可能会使人更加虚弱。我们的团队目前正在进行两条重要的研究路线，旨在严格测试干预措施，以解决各种其他健康状况的差异。社区卫生工作者（CHW）是一种非常有前途的方法，但来自随机对照试验的证据有限。我们小组还在少数族裔中测试移动医疗解决方案。我们建议通过CHW/ ProMobile联合干预来扩展这项工作。研究设计将是一项实用的临床试验，300名拉丁裔患者在我们的中风登记处接受急性缺血性中风，出院时残疾程度为中度或更轻。干预将包括CHW家访、辅导电话和小组会议。基于手机的互动将包括血压监测和量身定制的教育信息。我们将确定建议的干预措施是否能改善最重要的卒中复发危险因素收缩压。我们还将检查其他危险因素，包括胆固醇，药物依从性，以及糖尿病患者的血糖控制。我们研究的一个优势在于，它将利用现有资源，包括我们最近资助的中风差异项目和CTSA。我们期望我们的转化研究项目将为潜在的治疗方法提供新的见解，这些方法可以改变医疗实践，改善拉丁美洲中风人群的健康结果。中风是导致死亡和功能损伤的主要原因。中风对拉丁裔人群的影响也不成比例。在西班牙二级中风预防倡议中，我们提出了一项使用社区卫生工作者（CHW）和移动电话技术的研究，以降低拉丁美洲人二次中风和潜在的严重衰弱中风的高风险复发性中风的风险。

DESCRIPTION (provided by applicant): Stroke is the main preventable cause of adult disability in the US. Stroke also disproportionately impacts the Hispanic population whose rapid growth and aging will lead to dramatic future increases in the public health impact of stroke. In the Hispanic Secondary Stroke Prevention Initiative we propose a translational research project aimed at reducing the risk for a recurrent stroke. Our focus is on patients having had a stroke since they have over a 25% risk of a recurrent and potentially much more debilitating stroke in the next five years. Our team is currently pursuing two important lines of research aimed at rigorously testing interventions to address disparities in a variety of other health conditions. On is Community Health Workers (CHW), a highly promising approach, for which evidence from RCTs is limited. Our group is also testing mobile health solutions among minorities. We propose to extend this work through a combined CHW/ ProMobile intervention. The study design will be a pragmatic clinical trial of 300 Latino patients in our stroke registry admitted with an acute ischemic stroke and having a moderate disability or less at time of discharge. The intervention will include CHW home visits, coaching phone calls, and group sessions. Cell phone based interactions will include blood pressure monitoring and tailored education messages. We will determine if the proposed intervention results in improving the most important recurrent stroke risk factor which is systolic blood pressure. We will also examine other risk factors including cholesterol, medication adherence, and among diabetic patients, glycemic control. A strength of our study is that it will leverage existing resources, including those of our recently funded strok disparities program and our CTSA. We expect that our translational research project will provide new insights on potential approaches to treatment that can transform medical practice to improve health outcomes in Latino stroke populations. Stroke is a leading cause of death and functional impairments. Stroke also disproportionately affects Latino populations. In the Hispanic Secondary Stroke Prevention Initiative we propose a study using Community Health Workers (CHW) and mobile phone technologies to reduce the risk for a recurrent stroke among Latinos at high risk for second and potentially much debilitating stroke.