Social network intervention to improve blood pressure control after stroke: The TEAMS-BP randomized clinical trial

Amar Dhand; Katherine Crum; Kaitlin E Hanken; Gauri Bhatkhande; Melinda Luo; Ian M Corbin; George Usmanov; Zachary Rothfeld-Wehrwein; Vrushali Dhongade; David Lin; Chloe Slocum; Nancy Haff; Niteesh K Choudhry

doi:10.1016/j.socscimed.2025.118231

Social network intervention to improve blood pressure control after stroke: The TEAMS-BP randomized clinical trial

Soc Sci Med. 2025 May 21:380:118231. doi: 10.1016/j.socscimed.2025.118231. Online ahead of print.

Authors

Affiliations

¹ Brigham and Women's Hospital, Department of Neurology, 65 Landsdowne Street, Cambridge, MA, 02139, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA; Northeastern University, Network Science Institute, 177 Huntington Ave #1010, Boston, MA, 02115, USA. Electronic address: adhand@bwh.harvard.edu.
² Brigham and Women's Hospital, Center for Healthcare Delivery Sciences (C4HDS), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA.
³ Brigham and Women's Hospital, Department of Neurology, 65 Landsdowne Street, Cambridge, MA, 02139, USA.
⁴ Brigham and Women's Hospital, Department of Neurology, 65 Landsdowne Street, Cambridge, MA, 02139, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
⁵ Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA; Massachusetts General Hospital, Department of Neurology, Division of Neurocritical Care and Stroke Service, Center for Neurotechnology and Neurorecovery, Suite #310, 101 Merrimac St., Boston, MA, 02114, USA.
⁶ Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA; Spaulding Rehabilitation Hospital, 300 1st Ave, Charlestown, MA, 02129, USA.
⁷ Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA; Brigham and Women's Hospital, Center for Healthcare Delivery Sciences (C4HDS), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA.

PMID: 40414088
DOI: 10.1016/j.socscimed.2025.118231

Abstract

Social connections play an important role in predicting health outcomes after a stroke. In the context of clinical medicine, a social network theory proposes that each patient is embedded in a personal social network of interpersonal connections that provide social support, information, and behavioral cues. However, the effectiveness of activating and harnessing supportive personal social networks remains uncertain, particularly within healthcare situations where individualism prevails. As an initial step towards developing interventions for healthier social networks in clinical practice, we conducted a randomized controlled trial in stroke survivors. This trial compared a network intervention versus individual counseling for 3 months with the aim of lowering blood pressure after stroke. Over 2 years, we recruited 45 stroke survivors, with 24 assigned to the network intervention and 21 to the individual counseling group. Results indicated no significant difference in the primary outcome of absolute systolic blood pressure difference over 3 months between the two groups. However, subgroup analyses revealed that patients within small and close-knit networks, known as high constraint networks, who received the network intervention had a significantly larger reduction in blood pressure than patients within large and open, low constraint, networks. The study's findings are preliminary due to dropout rates in both arms, and variable engagement of network members in the intervention arm. Nevertheless, our results suggest the potential of leveraging social networks to enhance health outcomes in specific subgroups of stroke survivors, highlighting avenues for further research and intervention development. Clinical Trial Unique Identifier: NCT05258890.

Keywords: Blood pressure; Randomized controlled trial; Social networking; Social support; Stroke.

Associated data

ClinicalTrials.gov/NCT05258890