“Worth the Walk”: Culturally Tailored Stroke Risk Factor Reduction Intervention in Community Senior Centers

Abstract

Background Racial/ethnic minority older adults have worse stroke burden than non‐Hispanic white and younger counterparts. Our academic‐community partner team tested a culturally tailored 1‐month (8‐session) intervention to increase walking and stroke knowledge among Latino, Korean, Chinese, and black seniors. Methods and Results We conducted a randomized wait‐list controlled trial of 233 adults aged 60 years and older, with a history of hypertension, recruited from senior centers. Outcomes were measured at baseline (T0), immediately after the 1‐month intervention (T1), and 2 months later (T2). The primary outcome was pedometer‐measured change in steps. Secondary outcomes included stroke knowledge (eg, intention to call 911 for stroke symptoms) and other self‐reported and clinical measures of health. Mean age of participants was 74 years; 90% completed T2. Intervention participants had better daily walking change scores than control participants at T1 (489 versus −398 steps; mean difference in change=887; 97.5% CI, 137–1636), but not T2 after adjusting for multiple comparisons (233 versus −714; mean difference in change=947; 97.5% CI, −108 to 2002). The intervention increased the percent of stroke symptoms for which participants would call 911 (from 49% to 68%); the control group did not change (mean difference in change T0–T1=22%; 99.9% CI, 9–34%). This effect persisted at T2. The intervention did not affect measures of health (eg, blood pressure). Conclusions This community‐partnered intervention did not succeed in increasing and sustaining meaningful improvements in walking levels among minority seniors, but it caused large, sustained improvements in stroke preparedness. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 02181062.

Community- and Patient-Partner Engagement in Women’s Cardiovascular Disease Research: A Rapid Review of the Evidence

“…In addition, 12 published manuscripts were identified from a specific citation search; these were included as a compendium to the original record identified in the search (ie, full-text papers to support conference abstracts). In total, 35 records 62 , 63 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 were included in the final review.

Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses ( PRISMA) 2020 flow diagram.

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“…The 35 records represent data from 474 community and patient partners 62 , 63 , 67 , 68 , 70 , 71 , 73 , 74 , 75 , 76 , 77 , 78 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 89 , 90 , 91 , 96 , 97 , 98 , 99 who completed studies, including a total of 417 (88%) female partners. Of the 35 papers, the majority originated in the US (n = 16; 46%), 68 , 71 , 72 , 73 , 76 , 77 , 79 , 81 , 83 , 84 , 87 , 90 , 93 , 94 , 95 , 96 Canada ( n = 7; 20%), 62 , 63 , 69 , 70 , 74 , 75 , 98 and the UK (n = 6; 17%). 67 , 80 , 82 , 85 , 92 , 97 The remaining papers originated in Ireland (n = 1; 2%), 78 Sweden (n = 1; 2%), 86 Turkey (n = 1; 2%), 88 Germany (n = 1; 2%), 89 Denmark (n = 1; 2%), 91 and Greece (n = 1; 2%).…”

“… 67 , 80 , 82 , 85 , 92 , 97 The remaining papers originated in Ireland (n = 1; 2%), 78 Sweden (n = 1; 2%), 86 Turkey (n = 1; 2%), 88 Germany (n = 1; 2%), 89 Denmark (n = 1; 2%), 91 and Greece (n = 1; 2%). 99 Patient engagement focused on women with cerebrovascular disease and stroke (n = 19; 54.2%), 63 , 67 , 68 , 76 , 78 , 79 , 82 , 83 , 85 , 86 , 87 , 89 , 90 , 93 , 94 , 95 , 96 , 97 , 99 heart disease and myocardial infarction (n = 10; 28.6%), 62 , 63 , 73 , 74 , 76 , 80 , 84 , 91 , 94 , 98 and CVD and heart failure (n = 10; 28.6%). 69 , 70 , 71 , 72 , 75 , 77 , 81 , 83 , 88 , 92 Four were randomized controlled trials (RCTs), 69 , 84 .…”

Stroke Disparities: From Observations to Actions

“…They also worked on "Worth the Walk" -a culturally tailored 1-month intervention to increase walking and stroke knowledge among Latino, Korean, Chinese, and African American seniors. 78 Although they did not demonstrate an increase in walking levels among seniors, they did find improvement in stroke preparedness. The research teams also focused on Community Engagement Symposiums that were critical to their success.…”

Current Methods of Health Education by Nurses and Its Impact on Hypertension Patients: A Literature Review

“…Lifestyle changes and good physical activity can have an impact on changing blood pressure to normal in hypertensive patients (Chen, M. L et al, 2020). "Worth the Walk" is a physical activity for walking according to culture that can be done to prepare hypertension patients in preventing stroke complications (Menkin, J. A., 2019).…”