Stroke is the main preventable cause of adult disability in the US. Stroke also disproportionately impacts the Hispanic population whose rapid growth and aging will lead to dramatic future increases in the public health impact of stroke. In the Hispanic Secondary Stroke Prevention Initiative we propose a translational research project aimed at reducing the risk for a recurrent stroke. Our focus is on patients having had a stroke since they have over a 25% risk of a recurrent and potentially much more debilitating stroke in the next five years. Our team is currently pursuing two important lines of research aimed at rigorously testing interventions to address disparities in a variety of other health conditions. On is Community Health Workers (CHW), a highly promising approach, for which evidence from RCTs is limited. Our group is also testing mobile health solutions among minorities. We propose to extend this work through a combined CHW/ ProMobile intervention. The study design will be a pragmatic clinical trial of 300 Latino patients in our stroke registry admitted with an acute ischemic stroke and having a moderate disability or less at time of discharge. The intervention will include CHW home visits, coaching phone calls, and group sessions. Cell phone based interactions will include blood pressure monitoring and tailored education messages. We will determine if the proposed intervention results in improving the most important recurrent stroke risk factor which is systolic blood pressure. We will also examine other risk factors including cholesterol, medication adherence, and among diabetic patients, glycemic control. A strength of our study is that it will leverage existing resources, including those of our recently funded strok disparities program and our CTSA. We expect that our translational research project will provide new insights on potential approaches to treatment that can transform medical practice to improve health outcomes in Latino stroke populations. Stroke is a leading cause of death and functional impairments. Stroke also disproportionately affects Latino populations. In the Hispanic Secondary Stroke Prevention Initiative we propose a study using Community Health Workers (CHW) and mobile phone technologies to reduce the risk for a recurrent stroke among Latinos at high risk for second and potentially much debilitating stroke.

Public Health Relevance

Stroke is a leading cause of death and functional impairments and stroke risk factors (SRFs) disproportionately affect Latino populations. In the Hispanic Secondary Stroke Prevention Initiative (HiSSPI) we propose a study using Community Health Workers (CHW) and mobile technoloigies using cell phones to reducing the risk for a recurrent stroke among Latino stroke patients. The project examines the effectiveness of a combined multilevel intervention consisting of Community Health Workers and mobile based phone technologies in lowering of systolic blood pressure which is the most important risk factor for recurrent stroke.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Research Project (R01)
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Special Emphasis Panel (ZMD1-MLS (02))
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Rajapakse, Nishadi
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University of Miami School of Medicine
Internal Medicine/Medicine
Schools of Medicine
Coral Gables
United States
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