Barriers to acute stroke therapy and stroke prevention in Mexican Americans.
OBJECTIVE
The purpose of this study was to identify specific targets to improve acute stroke treatment and stroke prevention in the Mexican American (MA) community.


METHODS
A professional, academic survey research team provided structured questions and elicited responses from 719 subjects identified by random-digit dialing in the biethnic community of Corpus Christi, TEXAS: This community of approximately 300 000 is approximately half MA and half non-Hispanic white (NHW). The cooperation rate for the survey was 58%.


RESULTS
MAs (n=357) were younger, less well educated, and had lower family income than NHWs (n=362, P=0.001). MAs had a higher prevalence of diabetes mellitus (P=0.001) but similar rates of hypertension, elevated cholesterol, and current tobacco use. MAs less commonly recognized that acute stroke therapy existed (P=0.029), were less likely to acknowledge a time window for acute stroke treatment (P=0.001), and were more reticent to say they would call 911 for stroke symptoms (P=0.01) than NHWS: MAs were significantly less able to recall stroke symptoms and risk factors than NHWS: Only approximately 20% of both groups identified stroke as the NO: 1 cause of disability. MAs expressed less confidence in their ability to prevent stroke (P<0.001), more distrust in the medical establishment (P=0.007), and more concern that money impedes their seeking medical care (P<0.001).


CONCLUSIONS
There are significant barriers to both acute stroke treatment and stroke prevention in MAS: This study identifies specific targets amenable for testing in an intervention project following confirmation by a methodology other than telephone survey.
Morgenstern
L B
LB
Stroke Program, Department of Neurology, University of Texas Medical School, Houston, TX, USA. Lewis.Morgenstern@uth.tmc.edu
Steffen-Batey
L
L
Smith
M A
MA
Moyé
L A
LA
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000208:ethnology / Q000517:prevention & control* / Q000628:therapy*; D013781:Texas; D044465:White People / Q000706:statistics & numerical data