Enhancing Stroke Awareness and Activation Among High-Risk Populations: A Randomized Direct Mail Intervention in...

Area of Science:

• Public Health
• Health Communication
• Clinical Trials

Background:

• Many patients lack awareness of their personal stroke risk.
• Effective strategies are needed to engage patients in stroke risk reduction.

Purpose of the Study:

• To compare the impact of behaviorally tailored mailed messages on patient activation for stroke risk reduction.
• To assess the effectiveness of different message components (incentive, salience) in engaging high-risk patients.

Main Methods:

• A randomized clinical trial involving primary care patients from Veterans Health Administration (VA) and Eskenazi Health System (EHS).
• Patients in the highest stroke risk quintile received standard, incentive, salience, or incentive plus salience mailed messages.
• The primary outcome was patient response by calling a stroke prevention coordinator.

Main Results:

• The incentive message increased response rates in the EHS cohort (OR, 1.97).
• The incentive plus salience message increased response rates in the VA cohort (OR, 1.50).
• A significant proportion of responding patients (27-31%) were unaware of their stroke risk factors.

Conclusions:

• A mailed message with a monetary incentive is effective in engaging high-risk patients.
• Incorporating salience elements may further enhance engagement in specific patient populations.
• Patient unawareness of stroke risk underscores the importance of targeted health communication interventions.