Stroke literacy in Central Harlem

Willey, Joshua Z.; Williams, Olajide; Boden‐Albala, Bernadette

doi:10.1212/wnl.0b013e3181c51a7d

Cited by 67 publications

(73 citation statements)

References 19 publications

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“…Though the stroke literacy study by Willey et al found no significant difference in symptoms recognition between African Americans and Whites, recognition of blurred vision and headache was poor for both groups. 7 However, in our Baltimore-based study, 77.5% of participants identified "all of the above" (weakness, slurred speech, and vision loss) as the correct answer to a multiple choice question regarding stroke symptoms.…”

Section: Signs and Symptomsmentioning

confidence: 68%

“…Willey et al reported on a stroke literacy survey in Central Harlem in which 56.3% of African Americans compared with 72.7% of Whites correctly identified the brain in a multiple choice question. 7 Biederman et al reported on a telephone survey of two counties in North Carolina in which 59.6% of African Americans compared with 77.7% Whites answered correctly to an open-ended question that stroke occurs in the brain or head. 12 Similarly, 50.7% of participants in a telephone-based survey of African Americans in Detroit responded that a stroke occurs in the brain.…”

Section: Location Of Strokementioning

confidence: 99%

“…Most prior studies have shown that African Americans know the appropriate actions to take. 7,12,13,17,20,[22][23][24] However, when asked about actions for specific signs of stroke, individuals are generally less likely to choose the appropriate action. 12,17 This may indicate a simultaneous understanding of appropriate actions when faced with the certainty of stroke and inability to recognize individual symptoms as stroke, culminating in an overall loss of self-efficacy when faced with the challenge of recognizing stroke upon actual occurrence.…”

Section: Action For Strokementioning

confidence: 99%

“…3,4 Some approaches to addressing stroke disparities in African Americans have focused on improving risk factor awareness and control and increasing stroke literacy, which has been previously defined as the knowledge of stroke symptoms and risk factors. [5][6][7] Additional aspects of stroke literacy may include knowledge of treatment and appropriate stroke-related behavior.…”

mentioning

confidence: 99%

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Stroke Knowledge in African Americans: A Narrative Review

et al. 2016

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Objective: The purpose of this review is to evaluate the state of knowledge in regard to stroke literacy in African Americans. This topic is important for assessing the specific gaps in stroke knowledge for this population, as well as to evaluate the methodology that has been used to assess stroke literacy.Methods: This narrative review includes studies that evaluated and reported stroke knowledge in African Americans and were published between January 2000 and October 2015.Results: Our review revealed that disparities may exist in recognition of headache and visual symptoms, knowledge of the organ in which stroke occurs, and identification of tobacco use as a risk factor. Stress may be perceived as a more important risk factor among African Americans than among White Americans. The literature does not suggest disparities in knowledge of the appropriate action to take for stroke.Conclusions: Racial disparities may exist for specific domains of stroke knowledge. Future studies should explore specific gaps in knowledge to be addressed in stroke prevention interventions for African Americans. Standardization of methods is needed to aid comparisons across populations. The relationship between stroke knowledge and clinical outcomes also needs to be evaluated. Ethn Dis. 26(2):255-262; doi:10.18865/ed.26.2.255

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Section: Signs and Symptomsmentioning

confidence: 68%

Section: Location Of Strokementioning

confidence: 99%

Section: Action For Strokementioning

confidence: 99%

mentioning

confidence: 99%

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Stroke Knowledge in African Americans: A Narrative Review

et al. 2016

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“…Among individuals who survive a stroke, hemiparesis or hemiplegia is the most frequent m o t o r d e f i c i e n c y, w i t h c o r r e s p o n d i n g p h y s i c a l limitations 2,3) . The important issues in rehabilitation of stroke patients include restoring activity and participation.…”

Section: Introductionmentioning

confidence: 99%

Cane Length Influence on the Plantar Pressure Distribution of Adult Hemiplegia Patients

Kim

Cha

2011

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to investigate changes in plantar pressure distribution on the affected side related to arm length ratio to height of adult hemiplegia patients during gait.[Subjects] Twenty-four individuals with stroke were included in this study.[Methods] Subjects were divided into two groups according to the ratio of arm length to total height of each individual: group 1 had a ratio of less than 50% and group 2 had a ratio equal to or greater than 50%. The F-scan system was used to investigate the foot pressures of both feet with data captured during three strides.[Results] Group 1 showed greater increase in contact width, contact pressure, and peak contact pressure of the hind foot of the affected side. [Conclusion] With the use of a cane height standardized to the greater trochanter, group 1 was more effective than group 2 at increasing foot pressures of the hind foot on the affected side of stroke patients. The adjustment of cane length according to the individual's ratio of arm length to height, because of unique physical characteristics of individuals should be considered for patients with stroke who use a cane daily.

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Efficacy of a Discharge Educational Strategy vs Standard Discharge Care on Reduction of Vascular Risk in Patients With Stroke and Transient Ischemic Attack

et al. 2019

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IMPORTANCE Despite secondary prevention strategies with proven efficacy, recurrent stroke rates remain high, particularly in racial/ethnic minority populations who are disproportionately affected by stroke. OBJECTIVE To determine the efficacy of a culturally tailored skills-based educational intervention with telephone follow-up compared with standard discharge care on systolic blood pressure reduction in a multiethnic cohort of patients with mild/moderate stroke/transient ischemic attack. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial with 1-year follow-up. Participants were white, black, and Hispanic patients with mild/moderate stroke/transient ischemic attack prospectively enrolled from 4 New York City, New York, medical centers during hospitalization or emergency department visit between August 2012 and May 2016. Through screening of stroke admissions and emergency department notifications, 1083 eligible patients were identified, of whom 256 declined to participate and 275 were excluded for other reasons. Analyses were intention to treat. INTERVENTIONS The Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) intervention is a skills-based, culturally tailored discharge program with follow-up calls delivered by a community health coordinator. This intervention was developed using a community engagement approach. MAIN OUTCOMES AND MEASURES The primary outcome was systolic blood pressure reduction at 12 months postdischarge. RESULTS A total of 552 participants were randomized to receive intervention or usual care (281 women [51%]; mean [SD] age, 64.61 [2.9] years; 180 Hispanic [33%], 151 non-Hispanic white [27%], and 183 non-Hispanic black [33%]). At 1-year follow-up, no significant difference in systolic blood pressure reduction was observed between intervention and usual care groups (β = 2.5 mm Hg; 95% CI, −1.9 to 6.9). Although not powered for subgroup analysis, we found that among Hispanic individuals, the intervention arm had a clinically and statically significant 9.9 mm Hg-greater mean systolic blood pressure reduction compared with usual care (95% CI, 1.8-18.0). There were no significant differences between arms among non-Hispanic white (β = 3.3; 95% CI, −4.1 to 10.7) and non-Hispanic black participants (β = −1.6; 95% CI, −10.1 to 6.8). CONCLUSIONS AND RELEVANCE Few behavioral intervention studies in individuals who have had stroke have reported clinically meaningful reductions in blood pressure at 12 months, and fewer have focused on a skills-based approach. Results of secondary analyses suggest that culturally tailored, skills-based strategies may be an important alternative to knowledge-focused approaches in achieving sustained vascular risk reduction and addressing racial/ethnic stroke disparities; however, these findings should be tested in future studies. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01836354.

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Stroke literacy in Central Harlem

Abstract: Background: Awareness of stroke warning symptoms and risk factors (stroke literacy), as well as

Cited by 67 publications

References 19 publications

Stroke Knowledge in African Americans: A Narrative Review

Stroke Knowledge in African Americans: A Narrative Review

Cane Length Influence on the Plantar Pressure Distribution of Adult Hemiplegia Patients

Efficacy of a Discharge Educational Strategy vs Standard Discharge Care on Reduction of Vascular Risk in Patients With Stroke and Transient Ischemic Attack

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