Peer education for secondary stroke prevention in inner-city minorities: design and methods of the prevent recurrence of all inner-city strokes through education randomized controlled trial

Contemp Clin Trials. 2012 Sep;33(5):1065-73. doi: 10.1016/j.cct.2012.06.003. Epub 2012 Jun 15.

Abstract

Background: The highest risk for stroke is among survivors of strokes or transient ischemic attacks (TIA). However, use of proven-effective cardiovascular medications to control stroke risk is suboptimal, particularly among the Black and Latino populations disproportionately impacted by stroke.

Methods: A partnership of Harlem and Bronx community representatives, stroke survivors, researchers, clinicians, outreach workers and patient educators used community-based participatory research to conceive and develop the Prevent Recurrence of All Inner-city Strokes through Education (PRAISE) trial. Using data from focus groups with stroke survivors, they tailored a peer-led, community-based chronic disease self-management program to address stroke risk factors. PRAISE will test, in a randomized controlled trial, whether this stroke education intervention improves blood pressure control and a composite outcome of blood pressure control, lipid control, and use of antithrombotic medications.

Results: Of the 582 survivors of stroke and TIA enrolled thus far, 81% are Black or Latino and 56% have an annual income less than $15,000. Many (33%) do not have blood pressures in the target range, and most (66%) do not have control of all three major stroke risk factors.

Conclusions: Rates of stroke recurrence risk factors remain suboptimal in the high risk, urban, predominantly minority communities studied. With a community-partnered approach, PRAISE has recruited a large number of stroke and TIA survivors to date, and may prove successful in engaging those at highest risk for stroke and reducing disparities in stroke outcomes in inner-city communities.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • African Americans
  • Antihypertensive Agents / administration & dosage
  • Blood Pressure
  • Community-Based Participatory Research
  • Fibrinolytic Agents / administration & dosage
  • Hispanic Americans
  • Humans
  • Hypolipidemic Agents / administration & dosage
  • Ischemic Attack, Transient / complications
  • Lipids / blood
  • New York City
  • Patient Education as Topic / methods*
  • Randomized Controlled Trials as Topic / methods*
  • Recurrence
  • Risk Factors
  • Secondary Prevention / methods*
  • Self Care
  • Stroke / ethnology*
  • Stroke / prevention & control*
  • Urban Population*

Substances

  • Antihypertensive Agents
  • Fibrinolytic Agents
  • Hypolipidemic Agents
  • Lipids