Hispanic Stroke Prevention Intervention Research Program

描述（由申请人提供）：西班牙裔是美国最大的少数民族，到2050年将占美国人口的30%。虽然墨西哥裔美国人是最大的亚群，但加勒比裔美国人是美国第二大亚群。西班牙裔人口的老龄化和快速增长将导致中风影响的增加。需要创新的策略来降低卒中风险并消除西班牙裔之间的差异。我们的西班牙裔中风预防干预研究项目是迈阿密大学和波多黎各大学的合作项目，旨在减少西班牙裔社区中风的差异。我们项目的中心主题是西班牙裔中风风险因素的控制。在项目一中，我们将在一项随机试验中评估创新的二级卒中预防干预方案的有效性，以改善对风险因素的控制，使用在少数民族社区慢性病管理中取得成功的医疗服务模式，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，我们将系统地评估卒中患者高危西班牙裔家庭成员中血压变异性和血糖控制的决定因素。我们将评估新的社会心理、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，该模型将社会心理逆境、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港

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.