Culturally Tailoring a Stroke Intervention in Community Senior Centers
| Status: | Active, not recruiting |
|---|---|
| Conditions: | High Blood Pressure (Hypertension), Neurology |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Neurology |
| Healthy: | No |
| Age Range: | 60 - Any |
| Updated: | 10/18/2017 |
| Start Date: | October 2014 |
| End Date: | January 2018 |
Implementing and Testing a Culturally-Tailored Stroke Risk Factor Reduction Intervention in Community Senior Centers
Stroke is a cruel disease that disproportionately kills and disables African-Americans,
Latinos, Chinese-Americans and Korean-Americans; seniors with high blood pressure are at
particularly high risk. There is a higher incidence of hemorrhagic stroke in African
Americans, Latinos, and Chinese Americans relative to non-Latino whites. Asian-Americans have
up to 1.4 higher relative risk of stroke death compared to U.S. non-Latino whites. A critical
need therefore exists for a sustainable and scalable mechanism to disseminate
culturally-tailored stroke knowledge/prevention education in community-based settings where
large numbers of these high-risk ethnic minority older adult groups are regularly served,
such as in federally funded Multipurpose Senior Centers (MPCs) that exist across the nation
(16 of which are in Los Angeles alone).
The overall objective of the proposed study is to develop and test the implementation of a
training program for case managers at senior centers to implement a stoke
knowledge/prevention education program among four high-risk ethnic minority older adult
groups--Korean-American, Chinese-American, African-American, Latinos. We propose to develop a
culturally-tailored case manager training curriculum, implement the training at 4
community-based sites, and evaluate the training model using a randomized wait-list
controlled trial (n=244) testing the hypothesis that training case managers will decrease
older adult participants' stroke risk in a sustainable fashion through increasing their
preventative behavior (i.e. increasing their physical activity--mean steps/day--at 1 and 3
months).
Findings will inform similar community-academic partnership efforts around stroke and other
disease-specific prevention research/interventions; they will also determine next steps in
terms of whether this case manager-centric model can be scaled up and deployed in other
community-based settings.
Latinos, Chinese-Americans and Korean-Americans; seniors with high blood pressure are at
particularly high risk. There is a higher incidence of hemorrhagic stroke in African
Americans, Latinos, and Chinese Americans relative to non-Latino whites. Asian-Americans have
up to 1.4 higher relative risk of stroke death compared to U.S. non-Latino whites. A critical
need therefore exists for a sustainable and scalable mechanism to disseminate
culturally-tailored stroke knowledge/prevention education in community-based settings where
large numbers of these high-risk ethnic minority older adult groups are regularly served,
such as in federally funded Multipurpose Senior Centers (MPCs) that exist across the nation
(16 of which are in Los Angeles alone).
The overall objective of the proposed study is to develop and test the implementation of a
training program for case managers at senior centers to implement a stoke
knowledge/prevention education program among four high-risk ethnic minority older adult
groups--Korean-American, Chinese-American, African-American, Latinos. We propose to develop a
culturally-tailored case manager training curriculum, implement the training at 4
community-based sites, and evaluate the training model using a randomized wait-list
controlled trial (n=244) testing the hypothesis that training case managers will decrease
older adult participants' stroke risk in a sustainable fashion through increasing their
preventative behavior (i.e. increasing their physical activity--mean steps/day--at 1 and 3
months).
Findings will inform similar community-academic partnership efforts around stroke and other
disease-specific prevention research/interventions; they will also determine next steps in
terms of whether this case manager-centric model can be scaled up and deployed in other
community-based settings.
As many as 30% of ischemic strokes in the U.S. population can be attributed to physical
inactivity. With the goal of eliminating racial/ethnic stroke disparities, this
interdisciplinary team proposes to develop, implement, and test a culturally-tailored
behavioral intervention to reduce stroke risk (primary prevention) by increasing physical
activity (walking) for 4 different racial/ethnic groups (Korean-Americans, Chinese-Americans,
African-Americans and Latinos) in Los Angeles community senior centers. The intervention
combines stroke and stroke risk factor knowledge (using materials developed by the American
Heart Association and American Stroke Association) with theoretically-grounded behavioral
change techniques and focuses on reducing stroke risk by increasing physical activity
(walking). The study team will conduct focus groups (n=144) to identify culture-specific
beliefs about stroke and stroke risk factors, to assess the feasibility and acceptability of
the intervention, and will work with Community Action Panels to culturally-tailor the
intervention. The intervention will consist of 4 weeks of twice-weekly 1-hour group sessions
implemented at 4 community senior centers by trained case managers who are part of the
regular senior center staff and supported by congressionally-mandated Older Americans Act
Title III funding. The project team will test the effectiveness of the intervention in a
randomized wait-list controlled trial (n=240) testing the hypothesis that the intervention
will increase mean steps/day (measured by pedometer) at 1 and 3 months, and that the increase
will be mediated by changes in stroke/stroke risk knowledge and self-efficacy. Blood pressure
will be examined as a secondary outcome. In collaboration with the SPIRP Biomarker Collection
& Analysis Core, the team will collect biological specimens (finger pricks) to explore the
relationship between the intervention and biological markers of health; they will also
explore the relationship between the intervention and healthcare seeking or taking
medications to control stroke risk factors. The team will evaluate the barriers and
facilitators of successfully integrating the intervention into the senior centers in order to
inform large-scale implementation of the culturally-tailored stroke risk factor
reduction/walking intervention.
inactivity. With the goal of eliminating racial/ethnic stroke disparities, this
interdisciplinary team proposes to develop, implement, and test a culturally-tailored
behavioral intervention to reduce stroke risk (primary prevention) by increasing physical
activity (walking) for 4 different racial/ethnic groups (Korean-Americans, Chinese-Americans,
African-Americans and Latinos) in Los Angeles community senior centers. The intervention
combines stroke and stroke risk factor knowledge (using materials developed by the American
Heart Association and American Stroke Association) with theoretically-grounded behavioral
change techniques and focuses on reducing stroke risk by increasing physical activity
(walking). The study team will conduct focus groups (n=144) to identify culture-specific
beliefs about stroke and stroke risk factors, to assess the feasibility and acceptability of
the intervention, and will work with Community Action Panels to culturally-tailor the
intervention. The intervention will consist of 4 weeks of twice-weekly 1-hour group sessions
implemented at 4 community senior centers by trained case managers who are part of the
regular senior center staff and supported by congressionally-mandated Older Americans Act
Title III funding. The project team will test the effectiveness of the intervention in a
randomized wait-list controlled trial (n=240) testing the hypothesis that the intervention
will increase mean steps/day (measured by pedometer) at 1 and 3 months, and that the increase
will be mediated by changes in stroke/stroke risk knowledge and self-efficacy. Blood pressure
will be examined as a secondary outcome. In collaboration with the SPIRP Biomarker Collection
& Analysis Core, the team will collect biological specimens (finger pricks) to explore the
relationship between the intervention and biological markers of health; they will also
explore the relationship between the intervention and healthcare seeking or taking
medications to control stroke risk factors. The team will evaluate the barriers and
facilitators of successfully integrating the intervention into the senior centers in order to
inform large-scale implementation of the culturally-tailored stroke risk factor
reduction/walking intervention.
Inclusion Criteria:
- age 60 years and older
- reported history of high blood pressure
Exclusion Criteria:
- younger than 60 years of age
- not self-identifying as the racial-ethnic group for the intervention planned at that
site
- inability to communicate verbally in the appropriate language in a group setting
(either due to lack of language skills, hearing impairment, or other disability)
- inability to sit in a chair and participate in a 1-hour discussion session
- inability to walk (the use of assistive devices such as canes and walkers is not an
exclusion criterion)
- not available to attend the baseline data collection session and subsequent weekly
intervention sessions
- plans to move away from the region during the next 6 months
- lacking cognitive capacity to provide informed consent to participate
We found this trial at
4
sites
Click here to add this to my saved trials
Click here to add this to my saved trials
Click here to add this to my saved trials
Click here to add this to my saved trials