Four research centers will develop high impact culturally tailored interventions aimed at lowering stroke risk among racial and ethnic minorities in the U.S. Together the centers are expected to receive $40 million in funding over five years, contingent on the availability of funds from the National Institute of Neurological Disorders and Stroke (NINDS) part of NIH. One research project to be conducted by Kaiser Permanente Northern California and the University of California, San Francisco will identify African-American enrollees in the Kaiser system who have uncontrolled blood pressure. The enrollees in the controlled trial will be randomly assigned to one of three treatment groups to include an intensive monitoring and drug dosage adjustment program, a culturally tailored diet and exercise intervention, and the third group will receive usual care. The goal is to decrease the disparity in hypertension control between blacks and whites by 4 percent over one year
NYU Langone Medical Center and Columbia University Medical Center are going to create the Center for Stroke Disparities Solutions, a consortium that includes the State University of New York, Downstate Medical Center, Visiting Nurse Service of NY, five hospital-based stroke centers, and a research network of primary care practices within NY City’s Health and Hospital Corporation.
The first of the consortium’s three projects will compare home blood pressure monitoring alone versus home blood pressure monitoring with nurse case management by telephone. The study will track reductions in blood pressure and prevention of recurrent stroke among 450 black and Hispanic stroke survivors. A second project will study the vulnerable period when stroke survivors transition from the hospital to their homes. The third project will provide an educational video to African-American and Hispanic churches throughout New York City.
The project at the University of California, Los Angeles will focus on low-income Hispanic, African-American, and Asian-American populations in the Los Angeles basin area. The first study will measure if recurrent stroke risk is reduced when community health workers use mobile health technologies during home visits to empower recent stroke survivors to eat a healthy diet, exercise, and take medication to lower blood pressure. A second study will test the impact of culturally tailored messages about stroke warning signs and develop a campaign to encourage walking among senior center attendees.
A fourth research project will try to better identify the causes of stroke disparity. The Florida Puerto Rico Collaboration to Reduce Stroke Disparities will leverage resources from the University of Miami Miller School of Medicine, University of Puerto Rico, and Hospital HIMA-San Pablo Caguas.
The investigators will develop a registry of acute stroke patients treated at nearly 140 hospitals throughout Florida and Puerto Rico. The researchers hope to gain a better understanding of the underlying factors that contribute to higher stroke risk among racial and ethnic minorities.