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Addressing Disparities in Stroke Prevention for Atrial Fibrillation: Educational Opportunities
Rachel Karcher1, Adam E Berman2, Hartmut Gross2
1Med-IQ, Baltimore, MD rachel.karcher@gmail.com.
Summary
Racial disparities in atrial fibrillation (AF) stroke prevention persist in the US Stroke Belt. Addressing clinician bias and improving patient communication through cultural competency training can reduce these disparities.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Racial disparities in atrial fibrillation (AF)-related stroke and mortality are significant within the US "Stroke Belt."
- Optimal stroke prevention strategies are not consistently applied, exacerbating these disparities.
Purpose of the Study:
- To identify barriers contributing to racial disparities in AF stroke prevention.
- To develop a framework for clinician education to address these barriers.
Main Methods:
- A mixed qualitative-quantitative approach was employed, including regional surveys and one-on-one clinician interviews.
- An educational needs assessment focused on clinicians practicing within the Stroke Belt.
Main Results:
- Key barriers identified include implicit racial biases, lack of awareness of racial disparities in AF stroke risk, and insufficient multicultural training.
- Patient medical mistrust and communication challenges further contribute to disparities.
- General barriers include inconsistent risk assessment, underuse of standardized tools, discomfort with novel anticoagulants, and patient education deficits.
Conclusions:
- Cultural competency training is a vital strategy to mitigate AF-related stroke and mortality disparities.
- Training can improve clinician implicit bias, address medical mistrust, and enhance clinician-patient communication.