Community Engagement for Early Recognition and Immediate Action in Stroke (CEERIAS)
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||Community Engagement for Early Recognition and Immediate Action in Stroke|
- Early arrival after stroke onset [ Time Frame: 12 months ]Early hospital arrival will be defined as the proportion of stroke patients arriving within 3 hours from symptom onset to the 2 targeted primary stroke center hospitals
- Emergency medical services (EMS) utilization for stroke [ Time Frame: 12 months ]Emergency medical services (EMS) utilization (%) will be defined as the proportion of stroke patients arriving to the emergency department by EMS
- Knowledge, self-efficacy, and perceptions [ Time Frame: 12 months ]Change in stroke knowledge, self-efficacy, and perceptions in sample of residents living in the targeted neighborhoods
|Study Start Date:||October 2014|
|Estimated Study Completion Date:||September 2018|
|Estimated Primary Completion Date:||September 2017 (Final data collection date for primary outcome measure)|
Community-based Stroke Awareness Program
Neighborhoods in the south side of Chicago surrounding 2 primary stroke center hospitals will be targeted for a community-partnered stroke awareness and action educational campaign. To assess the effectiveness of this intervention, the investigators will monitor early hospital arrival and EMS use for stroke over a 60-month period at the 2 primary stroke center hospitals using an interrupted time-series analysis.
Behavioral: Community-based Stroke Awareness Program
A culturally-adapted stroke awareness and action program will be delivered by trained Stroke Promoters in the targeted neighborhoods in the south side of Chicago. Community Stroke Promoters will be trained on 1) the benefits of early recognition and EMS utilization for stroke (i.e. stroke centers, tPA), 2) culturally-adapted solutions to current barriers (i.e. misperceptions about vulnerability, severity, mistrust, costs), and 3) cues to aid in stroke recognition and immediate action. The intervention will take place at community settings throughout a 1-year period.
Other Name: Community Stroke Promoter Program
The CEERIAS community-partnered research project has the following specific aims:
- To examine personal, community, and cultural barriers to calling 911 after stroke onset and adapt a culturally-tailored intervention for delivery in multi-ethnic communities (African American, Hispanic, non-Hispanic White) surrounding 2 hospitals on the south side of Chicago;
- To implement a culturally-adapted stroke awareness and action program and monitor its penetration and adoption using the RE-AIM (Reach, Evaluate, Adoption, Implementation, Maintenance) framework in 2 multi-ethnic communities on the south side of Chicago; and
- To assess change in early hospital arrival and EMS use at 2 intervention hospitals before and after the community intervention.
For aim 1, the investigators will explore and identify facilitators and barriers to calling 911 for stroke through focus groups conducted and involving key stakeholders including children and adults, stroke survivors, neighborhood alderman/legislators, spiritual and community leaders, school teachers, and stroke advocacy group members. The CEERIAS team will test and culturally refine our core community-partnered pilot intervention for implementation.
For aim 2, the investigators will identify and train Stroke Promoters from collaborating community organizations on the adapted intervention techniques and messages, provide materials for public dissemination, and evaluate and monitor adoption and implementation in the surrounding communities.
For aim 3, the investigators will perform an interrupted time-series analysis of EMS use and early hospital arrival among stroke patients before and after our intervention in 2 south side Chicago communities. The research team will also compare time trends in EMS use and early hospital arrival for stroke with control PSCs on the north and west sides of Chicago and PSCs in St. Louis.
If the intervention is successful, the effect will be an increase in EMS use for stroke which will translate into earlier treatment for stroke and reduced death and disability. The CEERIAS results will be generalizable to other urban communities in the US and should be salient to other health emergencies such as heart attack and cardiac arrest.
Please refer to this study by its ClinicalTrials.gov identifier: NCT02301299
|Contact: Shyam Prabhakaran, MD MSfirstname.lastname@example.org|
|Contact: Erin Wymore, BA MSemail@example.com|
|United States, Illinois|
|Chicago, Illinois, United States, 60611|
|Contact: Erin Wymore, BA MS 312-503-3243 firstname.lastname@example.org|
|Contact: Shyam Prabhakaran, MD MS 312-503-2994 email@example.com|
|Principal Investigator:||Shyam Prabhakaran, MD MS||Northwestern University|
|Principal Investigator:||Neelum T Aggarwal, MD||Rush University Medical Center|
|Principal Investigator:||Knitasha Washington, DHA FACHE||Washington Howard and Associates|