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Still CH, Burant C, Moore S, Einstadter D, Killion C, Modlin C, Sundararajan S, Thornton JD, Wright JT, Sajatovic M. The Targeted Management (TEAM) Intervention for Reducing Stroke Risk in African American Men: Rationale and Study Design of a Prospective Randomized Controlled Trial. J Multidiscip Healthc 2021; 14:513-522. [PMID: 33654407 PMCID: PMC7914069 DOI: 10.2147/jmdh.s288753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/19/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND African American (AA) male survivors of strokes or transient ischemic attacks (TIA) have the highest risk of recurrent stroke when compared to other racial-ethnic men. However, there is a paucity of evidence-based strategies, including organizational, educational, or behavioral interventions, that targets secondary stroke risk reduction in AA men. METHODS Targeted Management for Reducing Stroke Risk (TEAM) is an ongoing, 6-month prospective, randomized controlled trial that will determine whether a curriculum-guided self-management approach, using peer dyads (men who had a stroke or TIA and their care partners) will improve post-stroke care in AA men. RESULTS The study sample will consist of 160 AA men who have experienced a stroke or TIA within 5 years, randomized to TEAM or Wait-list control group. The primary outcome changes in systolic blood pressure (BP) and high-density lipoprotein (HDL), while secondary outcomes include diastolic BP, total cholesterol, low-density lipoprotein, triglycerides, and glycemic control for diabetics. We hypothesize that AA men in TEAM will have significantly lower systolic BP and higher HDL when compared to AA men in the Wait-list control group at 6-month. CONCLUSION Persistent disparities for stroke burden in AA men highlight the need for novel interventions to promote secondary stroke-risk reduction. Building on promising pilot data, TEAM uses a group format, with a nurse and patient co-led intervention focused on AA men and family needs, practice in problem-solving, and attention to emotional and role management. In addition, the TEAM approach may help reduce stroke risk factors and health disparities in AA men. CLINICALTRIALSGOV IDENTIFIER NCT04402125.
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Affiliation(s)
- Carolyn H Still
- Frances Payne Bolton, School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Chris Burant
- Frances Payne Bolton, School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Shirley Moore
- Frances Payne Bolton, School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Doug Einstadter
- Center for Health Care Research and Policy, Case Western Reserve University, Cleveland, OH, USA
- The MetroHealth System, Cleveland, OH, USA
| | - Cheryl Killion
- Frances Payne Bolton, School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Charles Modlin
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sophia Sundararajan
- Case Western Reserve University, School of Medicine, Cleveland, OH, USA
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - John D Thornton
- The MetroHealth System, Cleveland, OH, USA
- Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH, USA
| | - Jackson T Wright
- Case Western Reserve University, School of Medicine, Cleveland, OH, USA
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Martha Sajatovic
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Department of Psychiatry and of Neurology, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
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Liu Z, Zhou X, Zhang W, Zhou L. Resilience and its correlates among first ischemic stroke survivors at acute stage of hospitalization from a tertiary hospital in China:a cross-sectional study. Aging Ment Health 2020; 24:828-836. [PMID: 30596461 DOI: 10.1080/13607863.2018.1550630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objectives: To measure the resilience of elderly patients with first ischemic stroke in mainland China and to identify variables that may be correlated with resilience at the acute stage of hospitalization.Methods: A cross-sectional survey was carried out in departments of neurology of two tertiary hospitals, where a convenience sample of one hundred and forty-seven elderly patients with first ischemic stroke voluntarily participated in our study. Resilience was assessed using the Chinese version of Connor-Davidson Resilience Scale with three dimensions (tenacity, strength, and optimism). The General Self-Efficacy Scale and Medical Coping Modes Questionnaire were applied to evaluate the respondents' general self-efficacy and coping style. Functional independency was also measured using the Functional Independency Measure.Results: The mean score of the 147 respondents' resilience was 62.51 ± 14.69. Together, general self-efficacy, resignation, confrontation, per capital monthly income, and being main source of family income explained 68.1% of the variance in resilience. General self-efficacy, resignation, and confrontation were the strongest explanatory factors. Specifically, 63.4% of the variance in tenacity was explained for general self-efficacy, resignation, being main source of family income, surgical history, and per capital monthly income. 63.2% of the variance in strength was ascribed to general self-efficacy, resignation, per capital monthly income and avoidance. 32.5% of the variance in optimism was attributed to general self-efficacy, religion, and resignation.Conclusion: General self-efficacy and coping style may be implied orientation in enhancing resilience of elderly patients with first ischemic stroke at acute hospitalization. Moreover, economic status may predict level of resilience.HighlightsResilience was measured in 147 older first-episode ischemic stroke survivors at acute hospitalization.General-efficacy was the strongest predictor of resilience.Resilience was significantly influenced by resignation.Coping strategy should be emphasized early after stroke.
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Affiliation(s)
- Zhihui Liu
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
| | - Xuan Zhou
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
| | - Wei Zhang
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
| | - Lanshu Zhou
- Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
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