A Community Partnership to Treat Stroke

描述(由申请人提供)：与欧洲美国人相比，非洲裔美国人中风的数量不成比例，导致中风后残疾和死亡率更高。尽管组织纤溶酶原激活酶(TPA)可降低中风后的发病率、死亡率并节省成本，但它仍未得到充分利用，特别是在非洲裔美国人中，他们接受tPA的可能性高达欧洲裔美国人的五分之一。急性中风治疗未得到充分利用的主要原因是延迟患者到医院就诊，这将通过增加中风的提示911电话来纠正。如果所有患者立即出现在医院，超过25%的中风患者将接受tPA治疗，而目前正在接受治疗的患者为1-3%。这一职业发展奖的长期目标是促进候选人发展成为专注于神经疾病健康差异的行为干预方面的临床和研究领导者。该项目的目的是1)开发和验证使用模拟中风患者视频片段的基于理论的中风教育干预材料和结果测量；2)评估基于信仰、科学理论驱动、同行领导的行为干预的可行性和可接受性，以提高密歇根州弗林特市非裔美国青年和成年人对中风的意识和拨打911的行为意图。该项目是基于与密歇根州弗林特的一个以非裔美国人信仰为基础的社区组织Bridges to the Future的合作伙伴关系，该组织将帮助设计和预先测试新型干预材料和结果评估。然后，将进行单组重复测量设计可行性研究，以获得我们适应性干预的影响的初步证据，并测试新的卒中结果测量。这位候选人致力于作为一名训练有素的临床科学家的职业生涯，需要额外的培训，以实现她通过行为干预减少神经疾病健康差距的长期目标。详细的职业发展计划将促进应聘者在行为干预科学、高级统计分析和对健康差距的跨学科理解方面的专业知识的发展。职业发展计划由上述每个领域的多学科专家小组组成，他们将监督这些领域的一系列正式课程、工作会议和实践经验，以确保候选人未来的成功。一所顶尖大学和一个指导团队的出色资源，以及在这些主题领域成功培养初级调查人员的证明，使密歇根大学成为该项目的理想环境。

DESCRIPTION (provided by applicant): African Americans suffer a disproportionate number of strokes resulting in greater post-stroke disability and mortality compared to European Americans. Despite the fact that tissue plasminogen activase (tPA), decreases post-stroke morbidity, mortality and is cost saving, it is underutilized especially among African Americans who are up to one-fifth as likely to receive tPA as European Americans. The primary reason for the underutilization of acute stroke treatments is delayed patient presentation to the hospital which would be remedied by increasing prompt 911 calls for stroke. If all patients presented to the hospital immediately over 25% of stroke patients would receive tPA compared with the 1-3% that are currently treated. The long-term goal of this career development award is to promote the candidate's development into a clinical and research leader in behavioral interventions focusing on health disparities of neurologic disease. The aims of this project are 1)To develop and validate theory-based stroke education intervention materials and outcome measures that use simulated stroke patient video vignettes; 2)To assess the feasibility and acceptability of a faith-based, scientific theory-driven, peer-led behavioral intervention to increase stroke awareness and behavioral intent to call 911 among African American youth and adults in Flint, Michigan. This project is based on a partnership with Bridges into the Future, an African American faith-based community group in Flint, Michigan who will help to design and pre test novel intervention materials and outcome assessments. Then a single group repeated measures design feasibility study will be conducted to obtain preliminary evidence for the impact of our adapted intervention and to test the novel stroke outcome measure. The candidate is committed to a career as a rigorously trained clinician scientist and requires additional training in order to accomplish her long-term goal of reducing health disparities in neurologic disease via behavioral interventions. A detailed career development plan will promote the candidate's development of expertise in the science of behavioral interventions, advanced statistical analysis and an interdisciplinary understanding of health disparities. The career development plan consists of a multidisciplinary team of experts in each of these areas who will oversee a range of formal coursework, working meetings and practical experiences in these areas to ensure the candidate's future success. Excellent resources of a top university and a mentoring team with demonstrated success in developing junior investigators in these topic areas makes the University of Michigan an ideal environment for this project.