Transient Ischemic Attack Clinical Trial
Official title:
Preventing Recurrence of All Inner-city Strokes Through Education
The purpose of this study is to evaluate if a peer-led stroke recurrence prevention intervention, versus usual care, will help reduce risk factors for recurrent strokes among adults in Harlem.
Twenty nine percent of the 700,000 strokes that occur yearly nationwide are among stroke
survivors. Blacks, both nationally and among Harlem residents, have a twofold increase in
recurrent strokes. Harlem Latinos have a threefold increase in risk relative to Whites.
Primary risk factors for recurrent stroke include hypertension, hyperlipidemia, and under
use of anti-thrombotic agents. Controlling risk factors can be particularly challenging for
low-income, minority populations who lack the resources needed to adhere to necessary
therapies. In Harlem, 72% of adults studied six months post stroke did not have these three
risk factors treated adequately.
We propose to determine if participation in a recurrent stroke prevention educational
intervention, versus usual care, can activated stroke survivors to at reduce primary risk
factors for recurrent strokes while providing an effective, low-cost, sustainable recurrent
stroke prevention program in neighborhoods like Harlem, whose residents bear a
disproportionate burden of suffering from strokes. Specifically, we propose:
1. Recruit 600 adults who sustained a stroke or transient ischemic attack (TIA) within the
past five years by working with Harlem community leaders, local clinical sites
including the Mount Sinai Medical Center and the Institute for Family Health, and the
Visiting Nurse Service of New York;
2. To conduct a randomized, controlled trial to determine if participation in a peer-led
stroke prevention program activates stroke and TIA survivors to improve their knowledge
and self-management strategies and treatments related to stroke prevention; and
3. To rigorously compare the impact of the intervention with usual care (delayed
intervention), on increasing the proportion of individuals with strokes and TIAs who
are appropriately treated to reduce the risk of recurrent events, specifically through
control of hypertension (blood pressure ≤ 140/90mmHg), hyperlipidemia (LDL
cholesterol≤100 mg/dl) and use of anti-thrombotic medicines.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Prevention
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