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Effect of peer education on stroke prevention: the prevent recurrence of all inner-city strokes through education randomized controlled trial.

Abstract：

BACKGROUND AND PURPOSE:Efforts to reduce disparities in recurrent stroke among Black and Latino stroke survivors have met with limited success. We aimed to determine the effect of peer education on secondary stroke prevention among predominantly minority stroke survivors. METHODS:Between 2009 and 2012, we enrolled 600 stroke or transient ischemic attack survivors from diverse, low-income communities in New York City into a 2-arm randomized clinical trial that compared a 6 week (1 session/week), peer-led, community-based, stroke prevention self-management group workshop (N=301) to a wait-list control group (N=299). The primary outcome was the proportion with a composite of controlled blood pressure (<140/90 mm Hg), low-density lipoprotein cholesterol <100 mg/dL, and use of antithrombotic medications at 6 months. Secondary outcomes included control of the individual stroke risk factors. All analyses were by intent-to-treat. RESULTS:There was no difference in the proportion of intervention and control group participants achieving the composite outcome (34% versus 34%; P=0.98). The proportion with controlled blood pressure at 6 months was greater in the intervention group than in the control group (76% versus 67%; P=0.02). This corresponded to a greater change in systolic blood pressure in the intervention versus control group (-3.63 SD, 19.81 mm Hg versus +0.34 SD, 23.76 mm Hg; P=0.04). There were no group differences in the control of cholesterol or use of antithrombotics. CONCLUSIONS:A low-cost peer education self-management workshop modestly improved blood pressure, but not low-density lipoprotein cholesterol or antithrombotic use, among stroke and transient ischemic attack survivors from vulnerable, predominantly minority urban communities. CLINICAL TRIAL REGISTRATION URL:http://www.clinicaltrials.gov/show/NCT0102727. Unique identifier: NCT01027273.

journal_name

Stroke

journal_title

Stroke

authors

Kronish IM,Goldfinger JZ,Negron R,Fei K,Tuhrim S,Arniella G,Horowitz CR

doi

10.1161/STROKEAHA.114.006623

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

3330-6

issue

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.114.006623

journal_volume

pub_type

杂志文章,随机对照试验

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Effect of peer education on stroke prevention: the prevent recurrence of all inner-city strokes through education randomized controlled trial.