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.

Public Health Relevance

The vision of the Center for Stroke Disparities Solutions is to reduce stroke disparities with a particular focus on prevention of recurrent stroke. This goal will be realized 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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
1U54NS081765-01
Application #
8452903
Study Section
Special Emphasis Panel (ZNS1-SRB-N (02))
Program Officer
Janis, Scott
Project Start
2012-09-30
Project End
2017-08-31
Budget Start
2012-09-30
Budget End
2013-08-31
Support Year
1
Fiscal Year
2012
Total Cost
$2,588,487
Indirect Cost
$552,592
Name
New York University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
121911077
City
New York
State
NY
Country
United States
Zip Code
10016
Seixas, Azizi A; Henclewood, Dwayne A; Langford, Aisha T et al. (2017) Differential and Combined Effects of Physical Activity Profiles and Prohealth Behaviors on Diabetes Prevalence among Blacks and Whites in the US Population: A Novel Bayesian Belief Network Machine Learning Analysis. J Diabetes Res 2017:5906034
Ortiz, Indira (2016) A Day in the Life of a Home Health Aide/Health Coach. Home Healthc Now 34:340-1
Ravenell, Joseph; Seixas, Azizi; Rosenthal, Diana Margot et al. (2016) Effect of birthplace on cardiometabolic risk among blacks in the Metabolic Syndrome Outcome Study (MetSO). Diabetol Metab Syndr 8:14
Williams, Stephen K; Ravenell, Joseph; Seyedali, Sara et al. (2016) Hypertension Treatment in Blacks: Discussion of the U.S. Clinical Practice Guidelines. Prog Cardiovasc Dis 59:282-288
Ojike, Nwakile; Ravenell, Joe; Seixas, Azizi et al. (2016) Racial Disparity in Stroke Awareness in the US: An Analysis of the 2014 National Health Interview Survey. J Neurol Neurophysiol 7:
Williams, Olajide; Leighton-Herrmann, Ellyn; DeSorbo, Alexandra et al. (2016) Effect of two 12-minute culturally targeted films on intent to call 911 for stroke. Neurology 86:1992-5
James, Caryl; Seixas, Azizi A; Harrison, Abigail et al. (2016) Childhood Physical and Sexual Abuse in Caribbean Young Adults and Its Association with Depression, Post-Traumatic Stress, and Skin Bleaching. J Depress Anxiety 5:
Seixas, A; Ravenell, J; Williams, N J et al. (2016) Uncontrolled blood pressure and risk of sleep apnea among blacks: findings from the Metabolic Syndrome Outcome (MetSO) study. J Hum Hypertens 30:149-52
Schoenthaler, Antoinette; Luerassi, Leanne; Silver, Stephanie et al. (2016) Comparative Effectiveness of a Practice-Based Comprehensive Lifestyle Intervention vs. Single Session Counseling in Hypertensive Blacks. Am J Hypertens 29:280-7
Jean-Louis, Girardin; Grandner, Michael (2016) Importance of recognizing sleep health disparities and implementing innovative interventions to reduce these disparities. Sleep Med 18:1-2

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