Physician-Researchers Awarded $1.9 Million to Reduce Hispanic Stroke Disparities

According to the American Heart Association, stroke is the fourth leading cause of death for Americans, and Hispanics face even higher risks, particularly for recurring stroke.

To improve stroke prevention methods, a team of multidisciplinary physician-researchers at the Miller School of Medicine and UHealth will team up for a new five-year $1.9 million grant from the National Institute on Minority Health and Health Disparities.

The Hispanic Secondary Stroke Prevention Initiative, led by Olveen Carrasquillo, M.D., M.P.H., professor of medicine and public health sciences, Chief of the Division of General Internal Medicine and Director of Community Engagement at the Miami Clinical and Translational Science Institute (CTSI), unites experts from the Departments of Medicine and Neurology, the Division of Gerontology and Geriatric Medicine, the Florida-Puerto Rico Collaboration to Reduce Disparities and the Clinical and Translational Science Award program. The team will collaborate on the translational research project to study ways to reduce the risk for recurrent stroke, the main preventable cause of adult disability in the United States.

“Hispanics are the nation’s fastest growing population, which is disproportionately affected by stroke,” Carrasquillo said. “This will significantly increase the public health impact of stroke in the future, so it is important to develop preventive strategies now.”

The initiative will examine the effectiveness of a combined multi-level intervention using Community Health Workers and mobile technologies in a pragmatic clinical trial of 300 Hispanic patients who have had an acute ischemic stroke and resulting disability. Community Health Workers will conduct home visits, coaching phone calls and group sessions, while cell phone-based interactions will include blood pressure monitoring and tailored education messages.

“Because mobile phones are a ubiquitous technology equipped with both text and voice capabilities, phone-based interventions, which provide a unique opportunity for automated monitoring, reminders and data gathering, are emerging as important tools to help providers care for patients,” said Stuti Dang, M.D., M.P.H., associate professor of clinical medicine in the Division of Gerontology and Geriatric Medicine, who will lead the mobile technology component of the study. “These frequent reminders should help promote disease self-management competency for controlling stroke risk factors and help prevent future strokes.”

The research team will determine if the interventions improve the most important recurrent stroke risk factor, which is systolic blood pressure. They also will examine other risk factors, including cholesterol, medication adherence and, among diabetic patients, glycemic control.

World-renowned stroke expert Ralph L. Sacco, M.D., M.S., professor and Chair of Neurology, Executive Director of the McKnight Brain Institute and the Olemberg Family Chair in Neurological Disorders, says the collaboration, which also includes the Stroke Division, led by Jose G. Romano, M.D., Chief and professor of clinical neurology, is essential to improve care for high-risk stroke patient populations.

“We are thrilled to collaborate with Dr. Carrasquillo and test his innovative approaches to controlling vascular risk factors post-stroke, using community health workers,” said Sacco, who is principal investigator of the NIH-funded Florida Puerto Rico Collaboration to Reduce Disparities established in 2013 to reduce stroke disparities across more than 70 hospitals in Florida and Puerto Rico. “Programs such as these that cross disciplines and departments and involve our community are just what we need to address stroke disparities and reduce the risk of recurrent strokes.”

Together with the efforts of other Miller School programs and departments to battle stroke disparities, Carrasquillo agrees that the multidisciplinary initiative will fortify collaborations and harmonize research findings.

“This project, strengthened by existing resources and partnerships with colleagues across the Miller School and UHealth, will provide new insights on potential treatments that can transform medical practices and improve health outcomes in Latino populations,” Carrasquillo said.

The work is supported by NIH grant number 1 R01 MD009164-01.

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