Brain Attack Surveillance in Corpus Christi (BASIC) Project

描述(申请人提供)：墨西哥裔美国人是人数最多的拉美裔美国人，也是美国最大的少数族裔人口。这一重要群体正在老龄化，并迅速增长。在过去的14年里，科珀斯·克里斯蒂的大脑攻击监测(BASIC)项目提供了丰富的原始中风差异研究，比较了墨西哥裔美国人和非西班牙裔白人。BASIC仍然是监测中风趋势和调查墨西哥裔美国人中风结局的唯一手段。BASIC研究表明，与非西班牙裔白人相比，墨西哥裔美国人的中风发病率更高。来自BASIC的新的中风发病率数据显示，在过去的十年中，这种差距仍然完全没有缩小。此外，在墨西哥裔美国人中，中风发病的年龄更小，残疾年限更长。与非西班牙裔白人相比，这导致墨西哥裔美国人中风的成本大幅增加。来自BASIC的引人注目的新数据表明，以前看到的墨西哥裔美国人中风后的生存优势正在消失。此外，墨西哥裔美国中风幸存者的神经和功能结果更差。因此，基本数据表明，2013年，墨西哥裔美国人的中风更多，发生在更年轻的年龄，中风后残疾的经历远远超过非西班牙裔白人。目前的提案寻求继续提供严格的中风监测，以监测墨西哥裔美国人和非西班牙裔白人的中风趋势。我们进一步建议提供新的较长期(六个月和一年)卒中结局数据，以提供两个种族卒中后神经、功能、认知和生活质量结局的时间进程和变化的关键信息。此外，由于中风后残疾在墨西哥裔美国人中似乎更严重，我们计划深入研究中风后非正式护理的结构，并了解中风幸存者的需求以及家庭在满足这些需求方面的作用。这些关于中风幸存者所处的社会/家庭环境的数据将对设计干预措施以改善中风预后至关重要。最后，将研究中风的定义，以了解基于种族多样性的人群研究对中风负担测量的影响。Basic出版了超过55篇经过同行评审的原创手稿，衍生出5项R-Level助学金，并作为培训众多不同学生的基础。在下一个周期中，我们准备并坚定地致力于提供对长期中风趋势、结果研究和非正式护理结构的基本了解，并继续提供关键的临床观察，如新中风定义的影响。这项工作对墨西哥裔美国人来说绝对是至关重要的，墨西哥裔美国人是一个不断增长、老龄化和庞大的少数族裔人口，在未来十年里，他们将越来越多地感受到中风的影响。事实上，这项工作对临床医生和公共卫生规划者也是至关重要的，因为Basic继续提供关于中风和墨西哥裔美国人健康差距的关键观察。

DESCRIPTION (provided by applicant): Mexican Americans are the most numerous sub-group of Hispanic Americans, the largest minority population in the United States. This important group is aging and growing rapidly. For the past 14 years the Brain Attack Surveillance in Corpus Christi (BASIC) Project has provided rich original stroke disparities research comparing Mexican Americans and non-Hispanic whites. BASIC remains the only means to monitor stroke trends and to investigate stroke outcomes in Mexican Americans. BASIC has demonstrated that stroke incidence is higher in Mexican Americans compared with non-Hispanic whites. New stroke incidence data from BASIC show that the disparity remains completely unabated over the last decade. Further, stroke onset occurs at younger ages in Mexican Americans providing more years of disability. This contributes to a substantial increased cost for stroke in Mexican Americans compared with non-Hispanic whites. Remarkable new data from BASIC suggests that the previously seen Mexican American survival advantage post-stroke is disappearing. Further, Mexican American stroke survivors have worse neurologic and functional outcomes. Thus, BASIC data suggests that in 2013 Mexican Americans have more strokes, occurring at younger ages, and experience far greater post- stroke disability than non-Hispanic whites. The current proposal seeks to continue to provide rigorous stroke surveillance to monitor stroke trends in Mexican Americans and non-Hispanic whites. We further propose to provide new longer-term (six month and one year) stroke outcome data to provide crucial information on the time course and changes in neurologic, functional, cognitive, and quality of life outcomes post-stroke in both ethnic groups. Additionally, since post-stroke disability appears much worse in Mexican Americans, we plan to delve deeply into the structure of informal caregiving post-stroke and understand the needs of stroke survivors and the role of families in addressing these needs. This data on the social/family context in which stroke survivors function will be crucial for designing intervention to improve stroke outcome. Finally, the definition of stroke will be studied to understand the impact on measures of stroke burden derived from an ethnically diverse population-based study. BASIC has published over 55 original, peer-reviewed manuscripts, spun-off 5 R-level grants and served as the foundation for training numerous diverse students. In this next cycle, we are poised and deeply committed to provide a fundamental understanding of long-term stroke trends, outcome studies, and informal caregiving structure, as well as continuing to provide key clinical observations such as the impact of the new stroke definition. This work is absolutely critical to Mexican Americans, a growing, aging and large minority population that will increasingly feel the impact from stroke in the next decade. Indeed, this work is also critical to clinicians and public health planners as BASIC continues to offer key observations on stroke and Mexican American health disparities.