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 HbA 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.
Background
African-Americans (AA) who experience a first time stroke are younger, and have double the stroke rate and more post-stroke complications than other Americans.
Objective
To assess perceived post-stroke care barriers among younger AA men and their care partners (CPs) in order to inform development of acceptable and effective improvements in post-stroke care for this high-risk group.
Methods
Ten community-dwelling AA stroke survivors and 7 of their care partners (CPs) participated in focus groups and advisory board meetings. Survivors had stroke or transient ischemic attack within one year and a Barthel ADL Index >60. In focus groups, using a semi-structured interview guide, survivors and CPs identified self-perceived barriers and facilitators to post-stroke care. Thematic analysis of session transcripts and the constant comparative method were used to generate themes.
Results
Survivor age ranged from 34 to 64. Mean Barthel was 95.5. CPs, all AA women, ranged in age from 49–61. CPs were 5 wives, a fianceé and a niece. Participants cited multiple personal, social, and societal stroke recovery challenges. While hypertension and smoking risks were acknowledged, stress, depression, PTSD, anger/frustration, personal identity change, and difficulty communicating unique needs as AA men were much more frequently noted. Facilitators included family support, stress reduction and dietary changes.
Conclusions
Younger AA men and their CPs perceive multiple post-stroke care barriers. Biological risk reduction education may not capture all salient aspects of health management for AA stroke survivors. Leveraging family and community strengths, addressing psychological health, and directly engaging patients with healthcare teams may improve care management.
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