title: Identification of Barriers to Stroke Awareness and Risk Factor Management Unique to Hispanics.
abstract: Barriers to risk factor control may differ by race/ethnicity. The goal of this study was to identify barriers to stroke awareness and risk factor management unique to Hispanics as compared to non-Hispanic whites (NHWs). We performed a prospective study of stroke patients from an academic Stroke Center in Arizona and surveyed members of the general community. Questionnaires included: the Duke Social Support Index (DSSI), the Multidimensional Health Locus of Control (MHLC) Scale, a stroke barriers questionnaire, and a Stroke Awareness Test. Of 145 stroke patients surveyed (72 Hispanic; 73 NHW), Hispanics scored lower on the Stroke Awareness Test compared to NHWs (72.5% vs. 79.1%, p = 0.029). Hispanic stroke patients also reported greater barriers related to medical knowledge, medication adherence, and healthcare access (p < 0.05 for all). Hispanics scored higher on the "powerful others" sub-scale (11.3 vs. 10, p < 0.05) of the MHLC. Of 177 members of the general public surveyed, Hispanics had lower stroke awareness compared to NHWs and tended to have lower awareness than Hispanic stroke patients. These results suggest that Hispanic stroke patients perceive less control over their health, experience more healthcare barriers, and demonstrate lower rates of stroke literacy. Interventions for stroke prevention and education in Hispanics should address these racial/ethnic differences in stroke awareness and barriers to risk factor control.
authors.affiliation: Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA. mgm2@email.arizona.edu.
authors.forename: Marina
authors.initials: M
authors.lastname: Martinez
authors.affiliation: Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA. nprabhakar@email.arizona.edu.
authors.forename: Nitin
authors.initials: N
authors.lastname: Prabhakar
authors.affiliation: Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA. kdrake@neurology.arizona.edu.
authors.forename: Kendra
authors.initials: K
authors.lastname: Drake
authors.affiliation: Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA. coullb@medadmin.arizona.edu.
authors.forename: Bruce
authors.initials: B
authors.lastname: Coull
authors.affiliation: Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA. jchong@neurology.arizona.edu.
authors.forename: Jenny
authors.initials: J
authors.lastname: Chong
authors.affiliation: Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA. lsr@email.arizona.edu.
authors.forename: Leslie
authors.initials: L
authors.lastname: Ritter
authors.affiliation: Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA. ckidwell@neurology.arizona.edu.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Kidwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona; D001294:Attitude to Health; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012308:Risk Management; D012959:Socioeconomic Factors; D020521:Stroke / Q000175:diagnosis* / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
keywords: Hispanics; prevention; stroke