EVALUATION OF STROKE DISPARITIES IN NATIVE HAWAIIANS AND OTHER PACIFIC ISLANDERS

脑出血(ICH)是一种破坏性的出血性中风，占 美国每年约有70万人中风，导致不成比例的高发病率 和死亡率。到目前为止，还没有明确的治疗方法可以逆转神经元损伤和 脑出血后预后的改善。因此，重要的是识别高危人群并将重点放在 一、二级预防，降低脑出血发病率和负担。最近的证据表明 非物质文化遗产的负担并不是所有人都平等地承担，据报道，少数族裔群体的负担更高 发病率和预后比白人差。尽管夏威夷原住民和其他太平洋岛民(NHPI) 据报道，与其他主要种族相比，心血管疾病的负担更高 在这些人群中，与脑出血相关的血管危险因素的负担还没有得到充分的研究。 此外，在NHPI中，脑出血后的长期功能结果和生活质量测量没有 已经研究过了。 这个项目的总体战略将是以我们对非物质文化遗产的初步工作的发现为基础 差异，利用女王医学中心的临床和研究专业知识，这是一所大学附属的 这家医院是太平洋地区主要的三级转诊中心，拥有该州最大的中风服务。 我们计划前瞻性地确定在女王医疗中心住院的急性脑出血患者， 并评估临床和社会人口学风险因素以及长期特定疾病的种族差异 与健康相关的生活质量和功能结果，将在3个月、6个月和12个月时进行测量 入场。我们假设NHPI种族与表现为脑出血的年龄越小有关，越好 脑出血后3个月的生活质量和较少的残疾 夏威夷。此外，我们将在一项随机对照试点研究中开发和测试一种文化知情的、 卒中患者导航计划对心理健康相关生活质量和卒中后的影响 非物质文化遗产幸存者中的抑郁。

Intracerebral hemorrhage (ICH) is a devastating hemorrhagic stroke that accounts for 10-15% of the approximately 700,000 annual strokes in the Unites States and results in disproportionately high morbidity and mortality. To date, there is no definitive treatment that results in reversal of neuronal injury and improvement in outcome after ICH. Therefore, it is important to identify the high-risk group and focus on primary and secondary prevention to reduce the incidence and burden of ICH. Recent evidence suggests that the burden of ICH is not borne equally by all, with racial minority groups reported to have a higher incidence and poorer outcomes than whites. Although Native Hawaiians and other Pacific Islanders (NHPI) have been reported to have higher burden of cardiovascular diseases compared to other major racial-ethnic groups, the burden of vascular risk factors related to ICH in this population has not been adequately studied. Furthermore, long-term functional outcome and quality-of-life measures after ICH among NHPI have not been studied. The overall strategy for this project will be to build on the findings from our preliminary work on ICH disparities, utilizing the clinical and research expertise at The Queen's Medical Center, a university-affiliated hospital that is the primary tertiary referral center in the Pacific and has the largest stroke service in the state. We plan to prospectively identify patients who are hospitalized at The Queen's Medical Center for acute ICH, and assess racial disparities in clinical and sociodemographic risk factors and long-term disease-specific health-related quality of life and functional outcomes, which will be measured at 3-, 6-, and 12-month from admission. We hypothesize that NHPI race is associated with younger age of presentation with ICH, better quality of life and less disability at 3 months after ICH compared to other major racial-ethnic groups in Hawaii. In addition, we will develop and test, in a randomized controlled pilot study, the impact of a culturally-informed, stroke-specific Patient Navigation program on psychological health-related quality of life and post-stroke depression among the ICH survivors.