Center for Stroke Disaparities Solution

描述（申请人提供）：我们寻求建立一个中风差异解决中心，作为三个学术机构之间的联合体（纽约大学医学院;哥伦比亚大学医学中心;和纽约州立大学医学院）;五个中风中心和纽约市（NYC）健康与医院公司（HHC）内基于实践的初级保健实践研究网络-美国最大的市政医疗保健系统位于里弗代尔的希伯来之家研究部和纽约的访问护士服务-美国最大的非营利家庭医疗保健组织。牵头机构是纽约大学医学院，目标社区是纽约市的黑人和西班牙裔居民。该中心的愿景是通过以下方式减少卒中差异，特别关注卒中复发的预防：1）在基于社区的初级保健实践和家庭医疗保健环境中实施针对卒中幸存者的高血压积极管理的循证干预措施; 2）传播新颖的、文化定制的基于社区的卒中健康教育;（3）培训少数民族研究者进行脑卒中差异研究。该中心的愿景将通过建立三个核心和三个研究项目来实现。行政核心（核心A）将监督所有行政、财务和传播活动。研究教育和培训计划（核心B）将培训初级教师级别的少数民族研究人员，以发展中风差异研究的成功学术生涯。研究核心（Core C）将为中心提供科学支持。核心A和C将支持所有3个项目：项目I：少数卒中幸存者家庭BP远程监测（HBPTM）的实践试验是一项比较HBPTM单独与HBPTM加电话护士病例管理在降低血压和预防复发性卒中方面效果的有效性试验。项目二：卒中社区过渡干预采用混合方法设计，以评估由执业护士和社区卫生工作者提供的文化定制的过渡护理计划在改善在家急性卒中后患者的BP控制，功能结局和生活质量方面的有效性。项目三：中风健康教育的定制方法使用混合方法设计来测试一种新颖的文化定制干预的有效性，这种干预使用讲故事（叙事说服）来增加纽约市黑人和西班牙裔教堂成年人的中风识字率。所有3个项目都解决了从社区到家庭护理和初级保健环境的中风护理连续性中出现的沿着障碍。

Description (provided by applicant): We seek to establish a Center for Stroke Disparities Solutions, as a consortium between three academic institutions (New York University School of Medicine; Columbia University Medical Center; and SUNY Downstate Medical School); five stroke centers and a practice-based research network of primary care practices within New York City's (NYC) Health and Hospital Corporation (HHC) - the largest municipal healthcare system in the U.S.; the Research Division of the Hebrew Home at Riverdale and the Visiting Nurse Service of New York - the largest nonprofit home healthcare organization in the US. The lead institution is New York University School of Medicine (NYUSOM) and the target communities are Black and Hispanic residents of NYC. The Center's vision is to reduce stroke disparities with a particular focus on prevention of recurrent stroke via: 1) implementation of evidence-based interventions targeted at aggressive management of hypertension among stroke survivors in community-based primary care practices and home healthcare settings; 2) dissemination of a novel, culturally-tailored community-based stroke health education; 3) training of minority investigators in stroke disparities research. The Center's vision will be achieved via the establishment of three cores and three research projects. The Administrative Core (Core A) will oversee all administrative, financial and dissemination activities. The Research Education and Training Plan (Core B) will train minority investigators at the junior faculty level to develop successful academic careers in stroke disparities research. The Research Core (Core C) will provide scientific support for the Center. Cores A and C will support all 3 projects: Project I: Practice-based Trial of Home BP Telemonitoring (HBPTM) Among Minority Stroke Survivors is a comparative effectiveness trial of the effects of HBPTM alone versus HBPTM plus telephonic nurse case management, on BP reduction and prevention of recurrent stroke. Project II: Stroke Community Transitions Intervention uses a mixed-methods design to evaluate the effectiveness of a culturally-tailored transition care program delivered by nurse practitioners and community health workers in improving BP control, functional outcomes and quality of life in homebound post-acute stroke patients. Project III: Tailored Approaches to Stroke Health Education uses a mixed-methods design to test the effectiveness of a novel culturally tailored intervention using storytelling (narrative persuasion) in increasing stroke literacy among adults in Black and Hispanic churches across NYC. All 3 projects address barriers that occur along the continuum of stroke care from the community to homecare, and primary care settings.