Tailored Approaches to Stroke Health Education (TASHE)

Columbia University

Status: Completed

Conditions: Stroke

Treatments: Behavioral: Stroke Education Film Viewing; Other: Stroke Education Pamphlet Exposure

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01909271

1U54NS081765-01 (U.S. NIH Grant/Contract)

AAAK5853

Details and patient eligibility

About

The overarching goal of the proposed intervention is to reduce stroke disparities by overcoming pre-hospital barriers related to emergency stroke treatment and facilitating the appropriate response to acute stroke using a novel culturally-tailored and sustainable approach developed by an experienced transdisciplinary team. Building on our previous work, in which the investigators have identified barriers to increasing stroke literacy and behavioral intent to call 911, the investigators will develop and evaluate the effectiveness of a novel, culturally tailored intervention using storytelling (narrative persuasion) in the form of two professionally produced 12-minute films (in English and Spanish), in minority populations in New York City (NYC). Behavioral intent to call 911 will be assessed immediately after viewing the film, 6 months later, and one year later.

Full description

Stroke is the leading cause of adult disability and costs U.S. taxpayers >$60 billion annually. Interventions designed to educate patients to seek treatment sooner when a stroke occurs may increase low rates of treatment with thrombolysis (current rates 3% national average). Thrombolysis can increase the odds of minimal to zero disability from stroke if emergency medical system response times and in-hospital response times are optimized (maximum time from symptom onset to intravenous thrombolysis is 4.5 hours). Black and Hispanic Americans have higher stroke incidence compared to Whites and are less likely to receive thrombolysis for acute stroke. The latency to hospital arrival is largely dependent on patients' recognition of stroke symptoms, and immediate presentation to the emergency department. The investigators have found very low stroke literacy rates among Blacks and Hispanics compared to Whites, which may, in part, be responsible for disparities in acute stroke treatment.

Enrollment: 290 patients

Sex: All

Ages: 34+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. No prior history of stroke;
2. High risk (defined as a history of one or more stroke risk factor (hypertension (HTN), diabetes, tobacco, abdominal obesity, heart disease, high cholesterol);
3. Over age 34 years at onset of intervention (we have selected this age cut off due to the large increase in stroke incidence among minority groups at age 34 );
4. Self-identified as Black or Hispanic; and
5. Member of a church congregation who lives in a household with a telephone.

Exclusion criteria

1. Participant is unable to give consent;
2. A modified Rankin score > 4 at baseline;
3. history of dementia; and
4. terminal illness, or other medical illness resulting in mortality < 1 year.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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290 participants in 2 patient groups

Intervention Group

Experimental group

Description:

Participants will receive education through a novel program called Stroke Education Film Viewing.

Treatment:

Behavioral: Stroke Education Film Viewing

Usual Care Group

Other group

Description:

Participants will receive education through Stroke Education Pamphlet Exposure.

Treatment:

Other: Stroke Education Pamphlet Exposure