Center for Stroke Disaparities Solution

描述（由申请人提供）：我们寻求建立一个中风差异解决方案中心，作为三个学术机构（纽约大学医学院、哥伦比亚大学医学中心和纽约州立大学下州医学院）之间的联盟；在纽约市（NYC）卫生与医院公司（HHC）内的五个中风中心和一个基于实践的初级保健实践研究网络-美国最大的市政医疗保健系统；Riverdale希伯来之家的研究部门和纽约探访护士服务——美国最大的非营利性家庭医疗保健组织。牵头机构是纽约大学医学院（NYUSOM），目标社区是纽约市的黑人和西班牙裔居民。该中心的愿景是通过以下方式减少卒中差异，特别关注卒中复发预防：1)在社区初级保健实践和家庭保健环境中实施循证干预措施，针对卒中幸存者的高血压积极管理；2)传播一种新颖的、有文化针对性的基于社区的脑卒中健康教育；3)卒中差异研究的少数民族调查员培训。中心的愿景将通过建立三个核心和三个研究项目来实现。行政核心（核心A）将监督所有行政、财务和传播活动。研究教育和培训计划（核心B）将培训初级教师水平的少数民族调查员，以在中风差异研究方面发展成功的学术生涯。研究核心（C核心）将为中心提供科学支持。项目一：在少数中风幸存者中进行家庭血压远程监测（HBPTM）的基于实践的试验是一项比较HBPTM单独与HBPTM加电话护士病例管理对降低血压和预防复发性中风效果的有效性试验。项目二：卒中社区过渡干预采用混合方法设计，评估由执业护士和社区卫生工作者提供的文化量身定制的过渡护理项目在改善急性卒中后居家患者血压控制、功能结局和生活质量方面的有效性。项目三：量身定制的中风健康教育方法使用混合方法设计来测试一种新颖的文化量身定制的干预措施的有效性，该干预措施使用讲故事（叙事说服）来提高纽约市黑人和西班牙裔教堂成年人的中风素养。所有这三个项目都解决了从社区到家庭护理和初级保健环境中卒中护理连续过程中出现的障碍。

Description (provided by applicant): We seek to establish a Center for Stroke Disparities Solutions, as a consortium between three academic institutions (New York University School of Medicine; Columbia University Medical Center; and SUNY Downstate Medical School); five stroke centers and a practice-based research network of primary care practices within New York City's (NYC) Health and Hospital Corporation (HHC) - the largest municipal healthcare system in the U.S.; the Research Division of the Hebrew Home at Riverdale and the Visiting Nurse Service of New York - the largest nonprofit home healthcare organization in the US. The lead institution is New York University School of Medicine (NYUSOM) and the target communities are Black and Hispanic residents of NYC. The Center's vision is to reduce stroke disparities with a particular focus on prevention of recurrent stroke via: 1) implementation of evidence-based interventions targeted at aggressive management of hypertension among stroke survivors in community-based primary care practices and home healthcare settings; 2) dissemination of a novel, culturally-tailored community-based stroke health education; 3) training of minority investigators in stroke disparities research. The Center's vision will be achieved via the establishment of three cores and three research projects. The Administrative Core (Core A) will oversee all administrative, financial and dissemination activities. The Research Education and Training Plan (Core B) will train minority investigators at the junior faculty level to develop successful academic careers in stroke disparities research. The Research Core (Core C) will provide scientific support for the Center. Cores A and C will support all 3 projects: Project I: Practice-based Trial of Home BP Telemonitoring (HBPTM) Among Minority Stroke Survivors is a comparative effectiveness trial of the effects of HBPTM alone versus HBPTM plus telephonic nurse case management, on BP reduction and prevention of recurrent stroke. Project II: Stroke Community Transitions Intervention uses a mixed-methods design to evaluate the effectiveness of a culturally-tailored transition care program delivered by nurse practitioners and community health workers in improving BP control, functional outcomes and quality of life in homebound post-acute stroke patients. Project III: Tailored Approaches to Stroke Health Education uses a mixed-methods design to test the effectiveness of a novel culturally tailored intervention using storytelling (narrative persuasion) in increasing stroke literacy among adults in Black and Hispanic churches across NYC. All 3 projects address barriers that occur along the continuum of stroke care from the community to homecare, and primary care settings.