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Demographic, Clinical and Social Determinants of Blood Pressure Control Among Black men who have had Stroke or Transient Ischemic Attack.

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The Targeted Management (TEAM) Intervention for Reducing Stroke Risk in African American Men: Rationale and Study

Carolyn H Still1, Chris Burant1, Shirley Moore1

  • 1Frances Payne Bolton, School of Nursing, Case Western Reserve University, Cleveland, OH, USA.

Journal of Multidisciplinary Healthcare
|March 3, 2021
PubMed
Summary

African American men face high recurrent stroke risk. The TEAM intervention uses peer support to improve self-management and reduce stroke risk factors in this population.

Keywords:
African-Americanshealth disparitiesstrokestroke preventiontransient ischemic attack

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Area of Science:

  • Neurology
  • Public Health
  • Cardiovascular Medicine

Background:

  • African American (AA) men exhibit the highest risk of recurrent stroke compared to other racial-ethnic groups.
  • Existing evidence-based strategies for secondary stroke risk reduction in AA men are limited.
  • Health disparities in stroke burden persist among AA men.

Purpose of the Study:

  • To evaluate the efficacy of the Targeted Management for Reducing Stroke Risk (TEAM) intervention.
  • To determine if a curriculum-guided self-management approach improves post-stroke care in AA men.
  • To reduce secondary stroke risk factors and health disparities in AA men.

Main Methods:

  • A 6-month prospective, randomized controlled trial involving 160 AA men with a history of stroke or transient ischemic attack (TIA) within 5 years.
  • Participants are randomized to either the TEAM intervention or a Wait-list control group.
  • The TEAM intervention utilizes peer dyads and a curriculum-guided self-management approach, co-led by nurses and patients, focusing on family needs, problem-solving, and emotional/role management.

Main Results:

  • The primary outcomes measured are changes in systolic blood pressure (BP) and high-density lipoprotein (HDL).
  • Secondary outcomes include diastolic BP, total cholesterol, low-density lipoprotein, triglycerides, and glycemic control.
  • Hypothesized outcomes: AA men in the TEAM group will demonstrate significantly lower systolic BP and higher HDL compared to the Wait-list control group at 6 months.

Conclusions:

  • Novel interventions are crucial to address persistent stroke disparities in AA men.
  • The TEAM intervention, with its group format and focus on AA men's needs, shows promise for secondary stroke risk reduction.
  • The TEAM approach has the potential to mitigate stroke risk factors and reduce health disparities in AA men.