The rapid diagnosis and treatment of acute ischemic stroke is critical in the reduction of morbidity, disability and stroke-associated mortality. While intravenous rt-PA is the only approved treatment for acute ischemic stroke, less than 2-3% of eligible individuals receive treatment. There are a number of reasons for the underutilization of rt-PA. Foremost is the inability to capture acute ischemic stroke cases within three hours of symptom onset. Populations at highest risk for stroke are still significantly undereducated about the need for rapid, emergency intervention immediately following onset of stroke symptoms. This is especially true among vulnerable populations including African Americans, Hispanics and the poor. Our primary objective is to determine whether a three session culturally sensitive interactive educational program called SWIFT (Stroke Warning Information and Faster Treatment) is more effective than usual care among a racially and ethnically diverse high-risk population. The goal of the intervention is to increase stroke knowledge, change behavior, and improve the time of arrival to the ED upon onset of stroke symptoms. To accomplish these aims we plan to randomize 1400 stroke/TIA patients and 1200 stroke free community residents into the SWIFT intervention versus usual care. All participants will be administered pre and post (30 days and 1 year) intervention stroke knowledge/behavior surveys. Comprehensive surveillance methodologies will measure arrival times for acute stroke among study participants for the length of the study. Our goal is to demonstrate that interactive strategies which promote the rapid identification of stroke symptoms; impart an urgency to obtain emergency medical treatment; and, aid in the navigation of emergency care will increase stroke awareness and decrease the individuals' response time to life saving stroke therapy.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center (P50)
Project #
1P50NS049060-01A1
Application #
6915975
Study Section
Special Emphasis Panel (ZNS1-SRB-K (01))
Project Start
2004-12-01
Project End
2009-05-31
Budget Start
2004-12-01
Budget End
2005-05-31
Support Year
1
Fiscal Year
2004
Total Cost
$472,670
Indirect Cost
Name
Columbia University (N.Y.)
Department
Type
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Yaghi, Shadi; Herber, Charlotte; Boehme, Amelia K et al. (2017) The Association between Diffusion MRI-Defined Infarct Volume and NIHSS Score in Patients with Minor Acute Stroke. J Neuroimaging 27:388-391
Dunn, Lauren E; Schweber, Adam B; Manson, Daniel K et al. (2016) Variability in Motor and Language Recovery during the Acute Stroke Period. Cerebrovasc Dis Extra 6:12-21
Yaghi, Shadi; Herber, Charlotte; Willey, Joshua Z et al. (2015) Itemized NIHSS subsets predict positive MRI strokes in patients with mild deficits. J Neurol Sci 358:221-5
Lantigua, Hector; Ortega-Gutierrez, Santiago; Schmidt, J Michael et al. (2015) Subarachnoid hemorrhage: who dies, and why? Crit Care 19:309
Yaghi, Shadi; Elkind, Mitchell S V (2015) Lipids and Cerebrovascular Disease: Research and Practice. Stroke 46:3322-8
Boden-Albala, Bernadette; Stillman, Joshua; Roberts, Eric T et al. (2015) Comparison of Acute Stroke Preparedness Strategies to Decrease Emergency Department Arrival Time in a Multiethnic Cohort: The Stroke Warning Information and Faster Treatment Study. Stroke 46:1806-12
Boden-Albala, Bernadette; Southwick, Lauren; Carman, Heather (2015) Dietary interventions to lower the risk of stroke. Curr Neurol Neurosci Rep 15:15
Dhamoon, Mandip S; McClure, Leslie A; White, Carole L et al. (2014) Quality of life after lacunar stroke: the Secondary Prevention of Small Subcortical Strokes study. J Stroke Cerebrovasc Dis 23:1131-7
Willey, Joshua Z; Khatri, Pooja; Khoury, Jane C et al. (2013) Variability in the use of intravenous thrombolysis for mild stroke: experience across the SPOTRIAS network. J Stroke Cerebrovasc Dis 22:318-22
Boden-Albala, Bernadette; Quarles, Leigh W (2013) Education strategies for stroke prevention. Stroke 44:S48-51

Showing the most recent 10 out of 41 publications