title: Improving secondary stroke self-care among underserved ethnic minority individuals: a randomized clinical trial of a pilot intervention.
abstract: The overall purpose of this study was to pilot a multibehavioral, brief, stroke self-care treatment adapted for implementation with underserved racial/ethnic minority groups and to test the moderating effects of anxiety and depression on engagement in secondary stroke-prevention behaviors. Fifty-two participants were randomized to the secondary stroke prevention (STOP) (N = 27) or usual care (N = 25) group. The STOP program consisted of 3 culturally tailored information sessions and goal-setting activities that were delivered in person by a research assistant. Participants were assessed at baseline and 4-week follow-up for stroke knowledge, exercise, fruit and vegetable consumption, tobacco and alcohol use, and medication adherence (primary outcomes) and anxiety and depression (moderator variables). Between-groups analysis of covariance and logistic multiple regressions revealed significant between-group differences for stroke knowledge, tobacco use and moderating effects between tobacco and anxiety, and improved alcohol use. The STOP program decreased secondary stroke risk factors among underserved racial/ethnic minorities and should be tested in large-scale trials.
authors.affiliation: VA HSR&D Houston Center of Excellence, Michael E. DeBakey VA Medical Center (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX, 77020, USA, ginae@bcm.edu.
authors.forename: Gina L
authors.initials: GL
authors.lastname: Evans-Hudnall
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Stanley
authors.forename: Allison N
authors.initials: AN
authors.lastname: Clark
authors.forename: Amber L
authors.initials: AL
authors.lastname: Bush
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Kass
authors.forename: Angelle M
authors.initials: AM
authors.lastname: Sander
mesh_terms: D001007:Anxiety / Q000150:complications / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000150:complications / Q000628:therapy; D004032:Diet; D005006:Ethnicity / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology; D010865:Pilot Projects; D055502:Secondary Prevention / Q000379:methods*; D012648:Self Care / Q000523:psychology; D020521:Stroke / Q000451:nursing / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D035862:Vulnerable Populations / Q000523:psychology