Strokes have increased among young adults, and African Americans have a greater prevalence of stroke risk factors than other racial/ethnic groups, a higher incidence of early-onset stroke and more severe stroke-related outcomes. The majority of strokes could be prevented if people recognized their personal risk factors and took steps to reduce their risks. However, many young African American adults do not perceive stroke as a threat. Thus, effective interventions are needed to improve these young African Americans awareness of stroke risk and increase their risk reduction behaviors. The purpose of this mentored research scientist development application is for the investigator to gain a foundation for an independent career focused on primary stroke prevention programs for African Americans. The immediate goals of the investigator are to gain the knowledge and skills needed to (1) design and refine sustainable, theory-based stroke risk assessment counseling and behavior change interventions for at-risk African Americans; (2) implement culturally sensitive behavioral interventions for stroke prevention; and (3) evaluate stroke interventions, including assessment of fidelity and use of advanced statistical methods. To accomplish these training goals and provide a foundation for a productive research career, the investigator will conduct a two-group randomized controlled trial of 116 at-risk African Americans aged 25 to 30 years to evaluate the investigator's Stroke COunseling for Risk REduction (SCORRE) intervention, which personalizes stroke information using age-and culturally relevant video vignettes of stroke champions (e.g., young, inspiring African American stroke survivors) and the American Heart Association's Life's Simple 7 (LS7) web-based, global risk assessment and education tool.
The aims of the proposed research are to (1) test the efficacy of the SCORRE intervention in improving accuracy of perceived stroke risk and increasing targeted risk reduction behaviors (i.e., physical activity, healthy diet, and smoking cessation), and (2) explore theoretical variabls (i.e., knowledge of stroke risk factors, motivation to change behaviors, self-efficacy for behavior change, and readiness for behavior change) and their relationships to increases and adherence to risk reduction behaviors. The results of the proposed study will inform a larger efficacy trial with a longer follow-up to determine the sustainability of the intervention effects. This research will address major stroke disparities by targeting African Americans early in life to reduce stroke risk through personalized stroke information and interventions.
The rise of stroke in young adults, the dramatic burden of stroke for African Americans, and current policies designed to strengthen primary care in the United States, provide an opportunity to expand primary stroke prevention efforts. Personalizing stroke risk information for young adult African Americans may result in greater awareness of risk and behavior changes that could reduce their chances of stroke in the future.
