A stroke preparedness RCT in a multi-ethnic cohort: design and methods

Area of Science:

• Neurology
• Public Health
• Health Disparities

Background:

• Acute ischemic stroke (IS) treatment with tissue plasminogen activator (tPA) is underutilized due to insufficient public awareness of stroke as an emergency.
• Raising awareness and recognition of stroke symptoms, especially in minority populations, is critical for improving IS outcomes.
• This study examines a stroke preparedness behavioral intervention in a multi-ethnic population of stroke and transient ischemic attack (TIA) survivors.

Purpose of the Study:

• To evaluate the efficacy of a culturally tailored, interactive stroke preparedness strategy.
• To collect baseline data on stroke parameters, knowledge, severity, social resources, and vascular risk in a diverse patient cohort.

Main Methods:

• The Stroke Warning Information and Faster Treatment (SWIFT) study prospectively identified and randomized IS and TIA patients.
• Data collection included demographic information, stroke characteristics, and stroke knowledge assessment.
• Culturally tailored interactive strategies were employed to promote behavioral change.

Main Results:

• The cohort of 736 participants included 76% IS and 24% TIA events, with 51% female representation.
• Demographics included 45% Hispanic, 26% White, and 25% Black participants, with high prevalence of hypertension, diabetes, and cardiac disease.
• Significant disparities were observed in time to emergency department arrival and stroke knowledge across ethnic groups.

Conclusions:

• Persistent disparities in stroke action and knowledge highlight the need for targeted interventions.
• Traditional written information has limited effectiveness in changing health behaviors.
• An interactive, culturally tailored intervention is proposed to address behavioral change in acute stroke management.