Background Prior studies have indicated high rates of vascular risk factors, but little is known about stroke in Hmong. Methods and Results The institutional Get With The Guidelines (GWTG) database was used to identify patients discharged with acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage between 2010 and 2019. Hmong patients were identified using clan names and primary language. Univariate analysis was used to compare Hmong and White patients. A subarachnoid hemorrhage comparison was not conducted because of the small sample size. We identified 128 Hmong patients and 3084 White patients. Hmong patients had more prevalent hemorrhagic stroke (31% versus 15%; P <0.0016). In the acute ischemic stroke cohort, compared with White patients, Hmong patients were younger (60±13 versus 71±15 years; P <0.0001), presented to the emergency department almost 4 hours later; and had a lower thrombolysis usage rate (6% versus 14%; P =0.03496), worse lipid profile, higher hemoglobin A 1C , similar stroke severity, and less frequent discharge to rehabilitation facilities. The most common ischemic stroke mechanism for Hmong patients was small‐vessel disease. In the intracerebral hemorrhage cohort, Hmong patients were younger (55±13 versus 70±15 years; P <0.0001), had higher blood pressure, and had a lower rate of independent ambulation on discharge (9% versus 30%; P =0.0041). Conclusions Hmong patients with stroke were younger and had poorer risk factor control compared with White patients. There was a significant delay in emergency department arrival and low use of acute therapies among the Hmong acute ischemic stroke cohort. Larger studies are needed to confirm these observations, but action is urgently needed to close gaps in primary care and stroke health literacy.

ObjectiveThe aim of the study was to identify causes for readmission to acute care of patients admitted to inpatient rehabilitation facility after stroke.DesignThe institutional Uniform Data System for Medical Rehabilitation database was used to identify stroke patients who experienced readmission to acute care and an equal number of age-/sex-matched group of patients who successfully completed their inpatient rehabilitation facility stay during 2005–2018. Retrospective chart review was used to extract clinical data. The two study groups were compared using univariate and multivariate analyses.ResultsThe rate of readmission to acute care was 4.7% (n = 89; age = 65 ± 14 yrs; 37% female; 65% White; 73% ischemic stroke). The most common indications for transfer were neurological (31%) and cardiovascular (28%). Compared with control group, the readmission to acute care group had statistically higher rates of comorbid conditions, lower median (interquartile range) Functional Independence Measure score on inpatient rehabilitation facility admission (55 [37–65] vs. 64 [51–78], P < 0.001), and a higher rate of sedative/hypnotic prescription (82% vs. 23%, P < 0.001).ConclusionsReadmission to acute care is not common in our cohort. Patients who experienced readmission to acute care had higher medical complexity and were prescribed more sedative/hypnotic medications than the control group. Practitioners should be vigilant in patients who meet these criteria.

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Objectives Childhood obesity is a critical public health issue with short and long-term health and financial burdens. Studies show that childhood obesity is higher among children of immigrant/refugee households compared to children whose parents were born in the United States. Poor child dietary intake is a critical risk factor for elevated obesity prevalence. Nonetheless, parents feeding practices are known to be associated with child dietary intake. Thus, this study aimed to examine the associations between length of residence time in the US of migrants/refugees, parents feeding practices, and child diet quality while also taking into consideration race/ethnicity. Methods Data are from baseline measures of a longitudinal cohort study called Family Matters. The sample includes 1307 children ages 5–9 and their families from six racial/ethnic backgrounds. Results Results showed that feeding practices of immigrant/refugee parents changed in relation to their length of residency in the US, in particular, with regard to using directive (e.g., restriction), non-directive (e.g., modeling), and emotional feeding practices. Additionally, race/ethnicity was found to influence the relation between time length in the US and parents feeding practices. Moreover, the diet quality score changed in relation to parents' length of time in the US. For example, Hmong children had the poorest diet quality compared to African American, Native American, Hispanic, Somali, and White children. Conclusions Future research should consider studying more in-depth why parent feeding practices may change when parents move to the US and explore whether there is a combination of parent feeding practices that are most useful in promoting healthful child diet quality. It is also important to further examine why child diet quality declines (e.g., Hmong children) with parents' time living in the US as a migrant/refugee. Funding Sources Research is supported by grant number R01HL126171 from the National Heart, Lung, and Blood Institute (PI: Berge). Content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute of the National Institutes of Health.

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