African Americans suffer a disproportionate number of strokes resulting in greater post-stroke disability and mortality compared to European Americans. Despite the fact that tissue plasminogen activase (tPA), decreases post-stroke morbidity, mortality and is cost saving, it is underutilized especially among African Americans who are up to one-fifth as likely to receive tPA as European Americans. The primary reason for the underutilization of acute stroke treatments is delayed patient presentation to the hospital which would be remedied by increasing prompt 911 calls for stroke. If all patients presented to the hospital immediately over 25% of stroke patients would receive tPA compared with the 1-3% that are currently treated. The long-term goal of this career development award is to promote the candidate's development into a clinical and research leader in behavioral interventions focusing on health disparities of neurologic disease.
The aims of this project are 1)To develop and validate theory-based stroke education intervention materials and outcome measures that use simulated stroke patient video vignettes;2)To assess the feasibility and acceptability of a faith-based, scientific theory-driven, peer-led behavioral intervention to increase stroke awareness and behavioral intent to call 911 among African American youth and adults in Flint, Michigan. This project is based on a partnership with Bridges into the Future, an African American faith-based community group in Flint, Michigan who will help to design and pre test novel intervention materials and outcome assessments. Then a single group repeated measures design feasibility study will be conducted to obtain preliminary evidence for the impact of our adapted intervention and to test the novel stroke outcome measure. The candidate is committed to a career as a rigorously trained clinician scientist and requires additional training in order to accomplish her long-term goal of reducing health disparities in neurologic disease via behavioral interventions. A detailed career development plan will promote the candidate's development of expertise in the science of behavioral interventions, advanced statistical analysis and an interdisciplinary understanding of health disparities. The career development plan consists of a multidisciplinary team of experts in each of these areas who will oversee a range of formal coursework, working meetings and practical experiences in these areas to ensure the candidate's future success. Excellent resources of a top university and a mentoring team with demonstrated success in developing junior investigators in these topic areas makes the University of Michigan an ideal environment for this project.
Getting to the hospital quickly is the key to treating stroke. African Americans suffer more strokes with worse outcomes and receive stroke treatments less often than European Americans. This project will work to reduce these health disparities by creating and testing the feasibility of a peer-led faith-based behavioral intervention in an African American community with a goal to increase calls to 911 so stroke patients can be treated quickly.
| Terman, Samuel W; Reeves, Mathew J; Skolarus, Lesli E et al. (2018) Association Between Early Outpatient Visits and Readmissions After Ischemic Stroke. Circ Cardiovasc Qual Outcomes 11:e004024 |
| Brenner, Allison B; Burke, James F; Skolarus, Lesli E (2018) Moving Toward an Understanding of Disability in Older U.S. Stroke Survivors. J Aging Health 30:75-104 |
| Braley, Tiffany J; Dunietz, Galit Levi; Chervin, Ronald D et al. (2018) Recognition and Diagnosis of Obstructive Sleep Apnea in Older Americans. J Am Geriatr Soc 66:1296-1302 |
| Gonzales, Sergio; Mullen, Michael T; Skolarus, Lesli et al. (2017) Progressive rural-urban disparity in acute stroke care. Neurology 88:441-448 |
| Skolarus, Lesli E; Freedman, Vicki A; Feng, Chunyang et al. (2017) African American Stroke Survivors: More Caregiving Time, but Less Caregiving Burden. Circ Cardiovasc Qual Outcomes 10: |
| Skolarus, Lesli E; Feng, Chunyang; Burke, James F (2017) No Racial Difference in Rehabilitation Therapy Across All Post-Acute Care Settings in the Year Following a Stroke. Stroke 48:3329-3335 |
| Skolarus, Lesli E; Mazor, Kathleen M; Sánchez, Brisa N et al. (2017) Development and Validation of a Bilingual Stroke Preparedness Assessment Instrument. Stroke 48:1020-1025 |
| Skolarus, Lesli E; Piette, John D; Pfeiffer, Paul N et al. (2017) Interactive Voice Response-An Innovative Approach to Post-Stroke Depression Self-Management Support. Transl Stroke Res 8:77-82 |
| Skolarus, Lesli E; Zimmerman, Marc A; Bailey, Sarah et al. (2016) Stroke Ready Intervention: Community Engagement to Decrease Prehospital Delay. J Am Heart Assoc 5: |
| Adelman, Eric E; Scott, Phillip A; Skolarus, Lesli E et al. (2016) Protocol Deviations before and after Treatment with Intravenous Tissue Plasminogen Activator in Community Hospitals. J Stroke Cerebrovasc Dis 25:67-73 |
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