As many as 30% of ischemic strokes in the U.S. population can be attributed to physical inactivity. With the goal of eliminating racial/ethnic stroke disparities, this interdisciplinary team proposes to develop, implement, and test a culturally-tailored behavioral intervention to reduce stroke risk (primary prevention) by increasing physical activity (walking) for 4 different racial/ethnic groups (Korean-Americans, Chinese-Americans, African-Americans and Latinos) in Los Angeles community senior centers. The intervenfion combines stroke and stroke risk factor knowledge (using materials developed by the American Heart Association and American Stroke Association) with theoretically-grounded behavioral change techniques and focuses on reducing stroke risk by increasing physical activity (walking). The study team will conduct focus groups (n=144) to identify culture-specific beliefs about stroke and stroke risk factors, to assess the feasibility and acceptability of the inten/ention, and will work with Community Acfion Panels to culturally-tailor the intervenfion. The intervention will consist of 4 weeks of twice-weekly 1-hour group sessions implemented at 4 community senior centers by trained case managers who are part of the regular senior center staff and supported by congressionally-mandated Older Americans Act Title III funding. The project team will test the effectiveness ofthe intervention in a randomized wait-list controlled trial (n=240) testing the hypothesis that the intervention will increase mean steps/day (measured by pedometer) at 1 and 3 months, and that the increase will be mediated by changes in stroke/stroke risk knowledge and self-efficacy. Blood pressure will be examined as a secondary outcome. In collaborafion with the SPIRP Biomarker Collecfion &Analysis Core, the team will collect biological specimens (fingerpricks) to explore the relafionship between the intervention and biological markers of health;they will also explore the relafionship between the intervenfion and healthcare seeking or taking medications to control stroke risk factors. The team will evaluate the barriers and facilitators of successfully integrating the intervention into the senior centers in order to inform large-scale implementafion ofthe culturally-tailored stroke risk factor reduction/walking intervention.

Public Health Relevance

Stroke is a cruel disease that disproportionately kills and disables racial/ethnic minority seniors. Our proposed study addresses the unmet need for identifying and testing feasible and sustainable intervenfions that reach high-risk minority seniors in their communities to prevent stroke by reducing a critical stroke risk factor - sedentary lifestyle. If successful, this intervenfion could be scalable and a model for the nation.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54NS081764-02
Application #
8551803
Study Section
Special Emphasis Panel (ZNS1-SRB-N)
Project Start
Project End
Budget Start
2013-09-01
Budget End
2014-08-31
Support Year
2
Fiscal Year
2013
Total Cost
$302,981
Indirect Cost
$106,240
Name
University of California Los Angeles
Department
Type
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Hamid, Hamada; Blackmon, Karen; Cong, Xiangyu et al. (2014) Mood, anxiety, and incomplete seizure control affect quality of life after epilepsy surgery. Neurology 82:887-94
Fogel, Brent L; Vickrey, Barbara G; Walton-Wetzel, Jenny et al. (2013) Utilization of genetic testing prior to subspecialist referral for cerebellar ataxia. Genet Test Mol Biomarkers 17:588-94
Berg, Anne T; Baca, Christine B; Loddenkemper, Tobias et al. (2013) Priorities in pediatric epilepsy research: improving children's futures today. Neurology 81:1166-75
Brown, Arleen F; Liang, Li-Jung; Vassar, Stefanie D et al. (2013) Neighborhood socioeconomic disadvantage and mortality after stroke. Neurology 80:520-7
Vickrey, Barbara G; Brott, Thomas G; Koroshetz, Walter J et al. (2013) Research priority setting: a summary of the 2012 NINDS Stroke Planning Meeting Report. Stroke 44:2338-42