Hispanic Stroke Prevention Intervention Research Program

描述(申请人提供)：拉美裔是最大的少数群体，到2050年将占美国人口的30%。虽然墨西哥裔美国人是美国最大的亚群体，但加勒比海拉美裔美国人是美国第二大亚群体。拉美裔人口的老龄化和快速增长将导致中风的影响增加。需要创新的战略来降低中风风险，消除拉美裔之间的差异。我们的拉美裔中风预防干预研究计划是迈阿密大学和波多黎各大学的合作应用程序，旨在减少拉美裔社区的中风差异。我们计划的中心主题是在有中风风险的拉美裔人中控制风险因素。在项目I中，我们将在随机试验中评估创新的二级中风预防干预计划的有效性，以改善风险因素的控制，使用已在少数族裔社区成功地进行慢性病管理的医疗保健提供模式，整合药剂师以提高依从性，以及最先进的移动信息技术。在项目II中，我们将系统地评估中风患者高危西班牙裔家庭成员的血压变异性和血糖控制的决定因素。我们将评估新的心理社会、社会文化、医疗保健系统和生物变量，作为概念模型的一部分，该概念模型将心理社会逆境、储备能力和累积脆弱性作为24小时血压变异性的决定因素。在项目III中，我们将创建佛罗里达州的波多黎各 RICO卒中登记处通过整理来自140家医院的数据，这些医院目前正在收集GET-卒中数据，以帮助按种族、民族和地区识别卒中差异，并教育利益相关者有关卒中差异的方法，以提高卒中质量。我们的项目包括三个核心：行政核心，研究/教育培训核心，数据管理和统计核心。我们的多学科计划联合了两个为少数族裔服务的机构的研究人员，解决了我们对拉美裔中风风险知识的重大差距，并将提供可能对未来的一级和二级中风预防努力产生立竿见影影响的结果。

DESCRIPTION (provided by applicant): Hispanics are the largest minority group and by 2050 will be constitute 30% of the US population. Although Mexican Americans are the largest subgroup, Caribbean Hispanics are the second largest subgroup in the U.S. The aging and rapid growth of the Hispanic population will lead to increases in the impact of stroke. Innovative strategies are needed to reduce stroke risk and eliminate disparities among Hispanics. Our Hispanic Stroke Prevention Intervention Research Program is a collaborative application from the University of Miami and the University of Puerto Rico aimed at reducing stroke disparities in the Hispanic community. The central theme of our program is risk factor control among Hispanics at risk of stroke. In project I, we will assess in a randomized trial the effectiveness o an innovative secondary stroke prevention intervention program to improve the control of risk factors, uses a health care delivery model that has been successful for chronic disease management in minority communities, integrates pharmacists in the enhancement of adherence, and state of the art mobile information technology. In project II, we will systematically evaluate the determinants of blood pressure variability and glucose control among high-risk Hispanic family members of stroke patients. We will assess novel psychosocial, sociocultural, healthcare system, and biological variables as part of a conceptual model that incorporates psychosocial adversities, reserve capacity, and cumulative vulnerabilities as determinants of 24hour blood pressure variability. In project III we will create the Florida Puerto Rico Stroke Registry by collating data from 140 hospitals that are currently collecting Get With the Guidelines-Stroke data to help identify stroke disparities by race, ethnicity, and region and educate stakeholders in approaches to improve stroke quality regarding stroke disparities. Our program includes three cores: administrative core, the research/education training core, and the data management and statistics core. Our multidisciplinary program unites investigators across two minority-serving institutions, addresses significant gaps in our knowledge of stroke risk in Hispanics, and will provide results that can have an immediate impact on future primary and secondary stroke prevention efforts.