The Los Angeles Stroke Prevention/ Intervention Research Program in Health Disparities is a partnership of UCLA, four medical centers in the Los Angeles County safety net system, Healthy African American Families, and representatives from multiple community organizations serving low-income minority communities that span the Los Angeles basin. In this most diverse county in the US in race/ethnicity, we propose a multi-disciplinary, highly collaborative Program to create and test sustainable interventions to reduce or eliminate racial and ethnic disparities in the occurrence of stroke, and to generate new knowledge about mechanisms for such disparities. Project I creates a strong community-based component with community health workers and mobile health technology to create a full-fledged Chronic Care Model intervention that will be tested relative to usual care in 500 patients with a recent stroke seen in the Los Angeles County safety net. A cost analysis and a formative evaluation will guide development of a financial sustainability plan. Project II will elucidate the role of novel biological and social risk factors for stroke risk and trends over time, in a nationa data set. Project III builds on an existing close partnership with the City of Los Angeles Department of Aging to develop and test a culturally-tailored behavioral stroke risk factor reduction/walking intervention - delivered by senior center staff-with 240 high risk seniors from Korean, Chinese, African-American and Hispanic racial/ethnic groups. Four cores include an Administrative Core A that supports all three projects; a Research Education and Training Core B that will recruit, retain, and develop stroke disparities-relevant curriculum for academic researchers, community research support personnel and other community stake holders; a Biomarker Collection and Analysis Core C to support Project I and III biomarker data collection, consulting for all three projects, and development of educational programming on biomarkers; and a Community Engagement, Outreach, and Dissemination Core D that supports and interacts with all three projects by promoting and sustaining community-academic partnerships through bidirectional knowledge sharing and by creating strategies for disseminating advances in knowledge about stroke prevention disparities research through outreach to affected communities locally and nationally.

Public Health Relevance

A coordinated effort of researchers and community partners is needed to reduce or eliminate the higher rates of stroke among low-income Latinos, African-Americans, and Asian Americans in underserved communities. The Los Angeles Stroke Prevention/Intervention Program in Health Disparities will carry out research, develop education programs, and share and learn from the community to meet this goal.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54NS081764-06
Application #
9125883
Study Section
Special Emphasis Panel (ZNS1)
Program Officer
Moy, Claudia S
Project Start
2012-09-30
Project End
2017-08-31
Budget Start
2016-09-01
Budget End
2017-08-31
Support Year
6
Fiscal Year
2016
Total Cost
Indirect Cost
Name
Icahn School of Medicine at Mount Sinai
Department
Neurology
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029
Cheng, Eric M; Cunningham, William E; Towfighi, Amytis et al. (2018) Efficacy of a Chronic Care-Based Intervention on Secondary Stroke Prevention Among Vulnerable Stroke Survivors: A Randomized Controlled Trial. Circ Cardiovasc Qual Outcomes 11:e003228
Bharmal, Nazleen H; McCarthy, William J; Gadgil, Meghana D et al. (2018) The Association of Religious Affiliation with Overweight/Obesity Among South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Relig Health 57:33-46
Ramirez, Magaly; Wu, Shinyi; Ryan, Gery et al. (2017) Using Beta-Version mHealth Technology for Team-Based Care Management to Support Stroke Prevention: An Assessment of Utility and Challenges. JMIR Res Protoc 6:e94
Towfighi, Amytis; Cheng, Eric M; Ayala-Rivera, Monica et al. (2017) Randomized controlled trial of a coordinated care intervention to improve risk factor control after stroke or transient ischemic attack in the safety net: Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Dispariti BMC Neurol 17:24
Cheng, Eric M; Myers, Laura J; Vassar, Stefanie et al. (2017) Impact of Hospital Admission for Patients with Transient Ischemic Attack. J Stroke Cerebrovasc Dis 26:1831-1840
Baca, Christine B; Barry, Frances; Vickrey, Barbara G et al. (2017) Social outcomes of young adults with childhood-onset epilepsy: A case-sibling-control study. Epilepsia 58:781-791
Ramirez, Magaly; Wu, Shinyi (2017) Phone Messaging to Prompt Physical Activity and Social Support Among Low-Income Latino Patients With Type 2 Diabetes: A Randomized Pilot Study. JMIR Diabetes 2:e8
Bharmal, Nazleen; Lucas-Wright, Anna Aziza; Vassar, Stefanie D et al. (2016) A Community Engagement Symposium to Prevent and Improve Stroke Outcomes in Diverse Communities. Prog Community Health Partnersh 10:149-58
Robinson, Maisha T; Vickrey, Barbara G; Holloway, Robert G et al. (2016) The lack of documentation of preferences in a cohort of adults who died after ischemic stroke. Neurology 86:2056-62
Lin, Michelle P; Ovbiagele, Bruce; Markovic, Daniela et al. (2016) Association of Secondhand Smoke With Stroke Outcomes. Stroke 47:2828-2835

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