Martha Sajatovic1,2, Curtis Tatsuoka2, Elisabeth Welter3, Kari Colon-Zimmermann3, Carol Blixen4,5, Adam T Perzynski4,5, Shelly Amato5, Jamie Cage6, Johnny Sams6, Shirley M Moore7, Svetlana Pundik8, Sophia Sundararajan9, Charles Modlin10, Cathy Sila9. 1. 1 Department of Psychiatry, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 2. 2 Department of Neurology, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 3. 3 Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland Western Reserve University School of Medicine, Cleveland, OH, USA. 4. 4 Center for Health Care Research and Policy, Case Western Reserve University, Cleveland, OH, USA. 5. 5 MetroHealth Medical Center, Cleveland, OH, USA. 6. 6 Case Western Reserve University, Cleveland, OH, USA. 7. 7 School of Nursing, Case Western Reserve University, Cleveland, OH, USA. 8. 8 Department of Neurology, Cleveland VA Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 9. 9 Department of Neurology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 10. 10 Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Abstract
PURPOSE: This study compared a novel self-management (TargetEd MAnageMent Intervention [TEAM]) versus treatment as usual (TAU) to reduce stroke risk in African American (AA) men. DESIGN: Six-month prospective randomized controlled trial with outcomes evaluated at baseline, 3 months, and 6 months. SETTING: Academic health center. PARTICIPANTS: Thirty-eight (age < 65) AA men who had a stroke or transient ischemic attack and a Barthel index score of >60 were randomly assigned to TEAM (n = 19) or TAU (n = 19). INTERVENTION: Self-management training, delivered in 1 individual and 4 group sessions (over 3 months). MEASURES: Blood pressure, glycosylated hemoglobin (HbA1c), lipids, medication adherence, weight, and standardized measures of health behaviors (diet, exercise, smoking, substances), depression, and quality of life. Qualitative assessments evaluated the perspectives of TEAM participants. ANALYSIS: T tests for paired differences and nonparametric tests. Thematic content qualitative analysis. RESULTS:Mean age was 52.1 (standard deviation [SD] = 7.4) and mean body mass index was 31.4 (SD = 7.4). Compared to TAU, TEAM participants had significantly lower mean systolic blood pressure by 24 weeks, and there was also improvement in HbA1c and high-density lipoprotein cholesterol ( P = .03). Other biomarker and health behaviors were similar between groups. Qualitative results suggested improved awareness of risk factors as well as positive effects of group support.
RCT Entities:
PURPOSE: This study compared a novel self-management (TargetEd MAnageMent Intervention [TEAM]) versus treatment as usual (TAU) to reduce stroke risk in African American (AA) men. DESIGN: Six-month prospective randomized controlled trial with outcomes evaluated at baseline, 3 months, and 6 months. SETTING: Academic health center. PARTICIPANTS: Thirty-eight (age < 65) AA men who had a stroke or transient ischemic attack and a Barthel index score of >60 were randomly assigned to TEAM (n = 19) or TAU (n = 19). INTERVENTION: Self-management training, delivered in 1 individual and 4 group sessions (over 3 months). MEASURES: Blood pressure, glycosylated hemoglobin (HbA1c), lipids, medication adherence, weight, and standardized measures of health behaviors (diet, exercise, smoking, substances), depression, and quality of life. Qualitative assessments evaluated the perspectives of TEAM participants. ANALYSIS: T tests for paired differences and nonparametric tests. Thematic content qualitative analysis. RESULTS: Mean age was 52.1 (standard deviation [SD] = 7.4) and mean body mass index was 31.4 (SD = 7.4). Compared to TAU, TEAM participants had significantly lower mean systolic blood pressure by 24 weeks, and there was also improvement in HbA1c and high-density lipoprotein cholesterol ( P = .03). Other biomarker and health behaviors were similar between groups. Qualitative results suggested improved awareness of risk factors as well as positive effects of group support.
Entities:
Keywords:
african americans; health disparities; hypertension; stroke; transient ischemic attack
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