Stroke continues to be a major focus of NINDS health disparities research efforts, as it remains one of the largest and most
burdensome disparities in neurological health with substantial opportunity for improving outcomes. NINDS supports research
to better understand stroke disparities and to inform development of effective interventions in specific population groups
who suffer a disproportionately higher burden of stroke.
- Stroke Prevention/Intervention Research Program (SPIRP)
The Stroke Prevention/Intervention Research Program is comprised of several scientifically rigorous culturally tailored interventions
that address major contributors to stroke disparities including risk factor control, re-engineered treatment delivery, and
state-wide barrier assessment and intervention. These multi-project cooperative agreements address major stroke disparities
research gaps and have dissemination planning, training/education and community outreach as major components of their programs.
The four funded SPIRP projects are described in the adjacent tab.
- Reasons for Geographic and Racial Differences in Stroke (REGARDS)
REGARDS (REasons for Geographic And Racial Differences in Stroke) is a large cohort study evaluating the causes of racial and geographic differences in stroke mortality and cognitive decline
in the United States. Between 2003 and 2007, the study enrolled 30,239 African-American and white participants aged 45 years
or older. Approximately half the participants reside in the Stroke Belt (including North Carolina, South Carolina, Georgia,
Alabama, Mississippi, Tennessee, Arkansas, and Louisiana), with the remaining participants residing in the other 40 contiguous
States; 42% are African-American. Medical and risk factor history were obtained by telephone interview and physical measurements
done at a baseline in-home visit, including blood pressure, anthropometry, electrocardiogram, and collection of blood and
urine samples. Participants are followed at 6-month intervals by telephone to assess stroke and other events. (Dr. George
- The Northern Manhattan Study (NOMAS)
The Northern Manhattan Study (NOMAS) is a prospective population-based study of stroke incidence, risk factors, and prognosis in a multiethnic, urban population.
Over 3,000 stroke-free individuals (63% Hispanic, 20% African-American, and 15% white residents) were enrolled between 1993
and 2001. Participants are screened annually by telephone to identify potential symptoms and events; those with positive screens
are subsequently examined in person. (Drs. Ralph Sacco and Mitchell Elkind, PIs)
- Stroke Disparities Program
The Georgetown University Stroke Disparities Program, is an integrated program of collaborative research designed to overcome
current gaps in stroke care in underserved populations in Washington, DC. The research projects address 3 key areas of health
disparities in stroke: 1) interventions to increase IV tPA utilization in underserved populations, 2) a health navigator intervention
to improve secondary stroke prevention, and 3) further study the disparities in primary intracerebral hemorrhage and its pathophysiology.
(Drs. Chelsea Kidwell, Bernadette Boden-Albala, and Alex Dromerick, Project PIs)
- Brain Attack Surveillance in Corpus Christi (BASIC)
The Brain Attack Surveillance in Corpus Christi (BASIC) project is a population-based study that examines the magnitude and etiologies of the stroke health disparity between Mexican
Americans and non Hispanic whites. BASIC has been collecting data since January 2000 and has published over 50 papers. (Drs.
Lewis Morgenstern and Lynda Lisabeth, PIs)
- Stroke Health And Risk Education (SHARE)
The Stroke Health and Risk Education (SHARE) study is a behavior change, educational intervention study aimed at primary stroke prevention for Mexican Americans and non
Hispanic whites in Corpus Christi, Texas. SHARE is a partnership between University of Michigan researchers and the Diocese
of Corpus Christi. (Drs. Lewis Morgenstern and Devin Brown, PIs)
- Hip Hop Stroke
Hip Hop Stroke is a musical multimedia stroke literacy intervention designed to raise stroke awareness and behavioral intent to call 911
for acute stroke. The intervention is based on validated theoretical models of behavior change and targets children aged 9-12
(proximal targets) from economically-disadvantaged communities, and their parents (distal targets) through "Child Mediated
Stroke Communication". Dr Williams and his research team are conducting a randomized controlled trial in New York City public
schools to evaluate the effect of Hip Hop Stroke on stroke literacy and stroke-related behaviors of children and their parents.
(Dr. Olajide Williams, PI)
- Stroke Warning Information and Faster Treatment (SWIFT)
The Columbia University's SWIFT (Stroke Warning information and Faster Treatment) study identifies actions/barriers toward optimal "Stroke Preparedness" within a multiethnic community. This study developed
an educational intervention which incorporated key preparedness skills and culturally tailored messages resulting in an increased
number of stroke events arriving within 3 hours of symptom onset in over 1200 individuals. (Dr. Bernadette Boden-Albala, Project
- Alaska Native Stroke Registry (ANSR)
The Alaska Native Stroke Registry (ANSR) is the first study of Alaska Native populations to document the incidence of stroke
among Native populations living in both rural and urban Alaska over a 4 year period. This work has also collected key information
in rural communities focused on vascular risk behaviors which may be linked to the rapid increase in stroke risk factors in
this culturally diverse Alaska Native population. (Drs. Bernadette Boden-Albala, James Allen, and Brian Trimble, Project PIs)
- A multi-ethnic comparative effectiveness study for diagnosis of cardiogenic stroke
DeCODE Genetics' A Multi-Ethnic Comparative Effectiveness Study for the Diagnosis of Cardiogenic Stroke is an observational study that utilizes extended cardiac rhythm monitoring in stroke patients and studies the association
of genetic variants to atrial fibrillation detection in blacks, whites, and Hispanics. (Dr. Jeffrey Gulcher, PI)
- Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS)
The Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) is a large, population-based study of temporal trends in stroke incidence, risk factors, treatment and outcome within a biracial
(African-American and white) population. Beginning in 1993, the GCNKSS identifies hospitalized and autopsied cases of stroke
and transient ischemic attack in the 5-county region through screening of all hospitals and coroner's offices as well as sampling
of nursing homes and physicians' offices. In addition, general population surveys have been conducted to assess stroke awareness
in the community. (Drs. Brett Kissela and Dawn Kleindorfer, PIs)
Below are examples of clinical trials that are particularly relevant to health disparities populations and may yield important
information about effectiveness of interventions in those groups.