Hispanics are the largest minority group and by 2050 will be constitute 30% of the US population. Although Mexican Americans are the largest subgroup, Caribbean Hispanics are the second largest subgroup in the U.S. The aging and rapid growth of the Hispanic population will lead to increases in the impact of stroke. Innovative strategies are needed to reduce stroke risk and eliminate disparities among Hispanics. Our Hispanic Stroke Prevention Intervention Research Program is a collaborative application from the University of Miami and the University of Puerto Rico aimed at reducing stroke disparities in the Hispanic community. The central theme of our program is risk factor control among Hispanics at risk of stroke. In project I, we will assess in a randomized trial the effectiveness o an innovative secondary stroke prevention intervention program to improve the control of risk factors, uses a health care delivery model that has been successful for chronic disease management in minority communities, integrates pharmacists in the enhancement of adherence, and state of the art mobile information technology. In project II, we will systematically evaluate the determinants of blood pressure variability and glucose control among high-risk Hispanic family members of stroke patients. We will assess novel psychosocial, sociocultural, healthcare system, and biological variables as part of a conceptual model that incorporates psychosocial adversities, reserve capacity, and cumulative vulnerabilities as determinants of 24hour blood pressure variability. In project III we will create the Florida Puerto Rico Stroke Registry by collating data from 140 hospitals that are currently collecting Get With the Guidelines-Stroke data to help identify stroke disparities by race, ethnicity, and region and educate stakeholders in approaches to improve stroke quality regarding stroke disparities. Our program includes three cores: administrative core, the research/education training core, and the data management and statistics core. Our multidisciplinary program unites investigators across two minority-serving institutions, addresses significant gaps in our knowledge of stroke risk in Hispanics, and will provide results that can have an immediate impact on future primary and secondary stroke prevention efforts.

Public Health Relevance

This specialized collaborative program will address stroke disparities in the Hispanic population. The projects have been designed to develop culturally-tailored approaches to secondary and primary stroke prevention, as well as identify and reduce acute stroke disparities. The studies will provide immediate results to reduce stroke disparities and transportable approaches to address stroke disparities in other communities.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54NS081763-02
Application #
8601760
Study Section
Special Emphasis Panel (ZNS1-SRB-N (02))
Program Officer
Moy, Claudia S
Project Start
2013-01-01
Project End
2017-12-31
Budget Start
2014-01-01
Budget End
2014-12-31
Support Year
2
Fiscal Year
2014
Total Cost
$737,938
Indirect Cost
$247,628
Name
University of Miami School of Medicine
Department
Neurology
Type
Schools of Medicine
DUNS #
052780918
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Gardener, Hannah; Pepe, Paul E; Rundek, Tatjana et al. (2018) Need to Prioritize Education of the Public Regarding Stroke Symptoms and Faster Activation of the 9-1-1 System: Findings from the Florida-Puerto Rico CReSD Stroke Registry. Prehosp Emerg Care :1-8
Asdaghi, Negar; Wang, Kefeng; Ciliberti-Vargas, Maria A et al. (2018) Predictors of Thrombolysis Administration in Mild Stroke: Florida-Puerto Rico Collaboration to Reduce Stroke Disparities. Stroke 49:638-645
Oluwole, Sofia A; Wang, Kefeng; Dong, Chuanhui et al. (2017) Disparities and Trends in Door-to-Needle Time: The FL-PR CReSD Study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities). Stroke 48:2192-2197
Ciliberti-Vargas, Maria A; Gardener, Hannah; Wang, Kefeng et al. (2017) Stroke Hospital Characteristics in the Florida-Puerto Rico Collaboration to Reduce Stroke Disparities Study. South Med J 110:466-474
Sacco, Ralph L; Gardener, Hannah; Wang, Kefeng et al. (2017) Racial-Ethnic Disparities in Acute Stroke Care in the Florida-Puerto Rico Collaboration to Reduce Stroke Disparities Study. J Am Heart Assoc 6:
Asdaghi, Negar; Romano, Jose G; Wang, Kefeng et al. (2016) Sex Disparities in Ischemic Stroke Care: FL-PR CReSD Study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities). Stroke 47:2618-26
Sacco, Ralph L (2015) Evolution from Stroke Risk Factors to Brain Health Determinants. Cerebrovasc Dis 40:102-13
Benito-León, Julián; Aleja, Jesús González de la; Martínez-Salio, Antonio et al. (2015) Symptomatic Atherosclerotic Disease and Decreased Risk of Cancer-Specific Mortality: A Prospective, Population-Based Study (NEDICES). Medicine (Baltimore) 94:e1287
Rundek, Tatjana; Brown, Devin L (2014) Socioeconomic status and subclinical atherosclerosis: are we closing disparity gaps? Stroke 45:948-9
Romano, Jose G; Sacco, Ralph L (2013) Quantifying and addressing persistent stroke disparities in Hispanics. Ann Neurol 74:759-61