Abstract WP453: Factors Associated With Dietary Patterns For Stroke Prevention In Young Adults

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Stacy M Perrin
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Health Literacy ◽  
Risk Reduction ◽  
Dietary Patterns ◽  
Perceived Risk ◽  
Stroke Risk ◽  
Perceived Competence ◽  
Self Report ◽  
Dietary Recommendations

Background/Purpose Hypertension, diabetes, and obesity have contributed to increased stroke rates in young adults; these risk factors are more prevalent among young adult African Americans (YAAA). Cardiovascular risk factors often result from poor lifestyle choices—diet; therefore preventable, as with most strokes. The purpose of this secondary data analysis was to explore relationships among perceptions of stroke risk, competence to live a healthy lifestyle, health literacy, and dietary patterns to reduce stroke risk in YAAA. Methods: A cross-sectional, correlational analysis was conducted using baseline data from the Stroke Counseling for Risk Reduction (SCORRE) study. SCORRE was guided by the Health Belief Model and used self-report questionnaires and biophysiological measures to assess the variables of interest in a community-based sample. Data were analyzed using Mann-Whitney U tests, Spearman’s Rho correlations and ANOVA. Results: Participants ( N =116) had a mean age of 25 ( SD =4.5) years, were mostly female (74%), college students, and averaged three modifiable stroke risk factors. Participants had poor dietary patterns based on the five AHA Life Simple 7 ® dietary recommendations; they averaged 1.6 ( SD =1.0). Participants perceived a low risk of future stroke ( M =2.5, SD =2.2); 53% had inaccurate risk perceptions. Health literacy levels ( M =4.4,SD=1.1) and perceived competence to live healthy (M=5.9, SD=1.1) were high. There was no association with health literacy/accuracy of perceived stroke risk ( p =.064); health literacy did not moderate the relationship between perceived competence to live healthy and dietary patterns. However, higher perceived risk of future stroke ( r s = -.22, p =.020) and lower perceived competence to live healthy ( r s =.27, p =.003) were significantly associated with poorer dietary patterns. Conclusions: As the incidence of stroke in young adults increases, the need for primary prevention interventions that focus on YAAA and dietary behaviors is paramount, regardless of health literacy levels. Assessing the perceived risk of future stroke and perceived competence to live healthy could help to identify those YAAA who may need more education and resources to achieve dietary recommendations for stroke risk reduction.

Abstract WP182: Trends in Acute Ischemic Stroke Hospitalizations and Risk Factors Among Young Adults: 12 Years of Nationally Representative Data

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Urvish K Patel ◽  
Priti Poojary ◽  
Vishal Jani ◽  
Mandip S Dhamoon
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Length Of Stay ◽  
Acute Ischemic Stroke ◽  
Stroke Risk ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Stroke Risk Factors

Background: There is limited recent population-based data of trends in acute ischemic stroke (AIS) hospitalization rates among young adults (YA). Rising prevalence of stroke risk factors may increase stroke rates in YA. We hypothesized that 1) stroke hospitalizations and mortality among YA are increasing over time (2000-2011), 2) besides traditional stroke risk factors, non-traditional factors are associated with stroke in YA, 3) stroke hospitalization among YA is associated with higher mortality, length of stay (LOS), and cost. Methods: In the Nationwide Inpatient Sample database (years 2000-2011), adult hospitalizations for AIS and concurrent diagnoses were identified by ICD-9-CM codes; the analytic cohort constituted all AIS hospitalizations. We performed weighted analysis using chi-square, t-test, and Jonckheere trend test. Multivariable survey regression models evaluated interactions between age group (18-45 vs. >45 years) and traditional and non-traditional risk factors, with outcomes including mortality, LOS, and cost. Models were adjusted for race, sex, Charlson’s Comorbidity Index, primary payer, location and teaching status of hospital, and admission day. Results: Among 5220960 AIS hospitalizations, 231858 (4.4%) were YA. On trend analysis, proportion of YA amongst AIS increased from 3.6% in 2000 to 4.7% in 2011 (p<0.0001) but mortality in YA decreased from 3.7% in 2000 to 2.6% in 2011, compared to 7.1% in 2000 to 4.6% in 2011 (p<0.0001) among older adults. Non-traditional, especially behavioral, risk factors were more common among YA, and LOS and cost were higher (Table). Conclusion: There was a trend for higher proportion of YA among AIS hospitalizations, though there was a decreasing mortality trend over 10 years. Behavioral risk factors were more common among YA, and there was an increased length of stay and cost. AIS in YA may require different preventive approaches compared to AIS among older adults.

Abstract P672: Black White Disparity in Multiple Risk Factors is Increased in Older Young Adults

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Prachi Mehndiratta ◽  
Kathleen Ryan ◽  
Adeolu Morawo ◽  
Seemant Chaturvedi ◽  
Carolyn A Cronin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Stroke Risk ◽  
Reference Group ◽  
Population Based ◽  
Multiple Risk Factors ◽  
Stroke In Young Adults ◽  
Multiple Risk ◽  
The Relationship ◽  
Control Study

Background: Stroke in young adults constitutes 15-18% of all ischemic strokes. Vascular risk factors contribute to stroke risk in young adults particularly older young adults. Few studies have addressed Black White differences in risk, stratified by age. We evaluated the prevalence of risk factors in the younger young (less than 40 years) vs. the older young adults (40 and above). Methods: A population based case control study with 1034 cases and 1091 controls, ages 15-49 was used to investigate the relationship between risk factors (DM, HTN, Smoking and Obesity) and stroke. Groups were defined by the number of risk factors (RF) among cases and controls : no risk factors (ref group), one RF, two RF, three RF and four RF. Prevalence of risk factors was determined in the entire population and stratified by age, sex and race. Logistic regression was used to determine odds of stroke based on the number of risk factors compared to the reference group. Results: The percent of cases with three or more risk factors was compared in different subgroups: ages 15-39 vs. 40-49 was 8.4 vs. 21.6, women vs. men was 15.6 vs. 18.6 and White vs. Black was 12.3 vs. 22.7. Among cases 40 years and older, Blacks were 3 times more likely than Whites (5.9 vs. 2) to have four or more risk factors.Across all age, race and sex subgroups, the odds of having a stroke increased exponentially with an increase in the number of risk factors. Conclusion: Blacks are more likely to have multiple risk factors than Whites. This difference is accentuated in those 40 years and older. Targeting young adults with multiple risk factors for preventive interventions would address a root case of excess stroke risk especially among Blacks.

scholarly journals Derivation and Application of a Tool to Estimate Benefits From Multiple Therapies That Reduce Recurrent Stroke Risk

Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1563-1569 ◽  
Author(s):  
Adam Richards ◽  
Nicholas J. Jackson ◽  
Eric M. Cheng ◽  
Robert J. Bryg ◽  
Arleen Brown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Reduction ◽  
Stroke Risk ◽  
Care Delivery ◽  
Recurrent Stroke ◽  
Individual Risk ◽  
Stroke Risk Factors ◽  
Multiple Stroke ◽  
Individual Risk Factors ◽  
Delivery Models

Background and Purpose— Lowering blood pressure and cholesterol, antiplatelet/antithrombotic use, and smoking cessation reduce risk of recurrent stroke. However, gaps in risk factor control among stroke survivors warrant development and evaluation of alternative care delivery models that aim to simultaneously improve multiple risk factors. Randomized trials of care delivery models are rarely of sufficient duration or size to be powered for low-frequency outcomes such as observed recurrent stroke. This creates a need for tools to estimate how changes across multiple stroke risk factors reduce risk of recurrent stroke. Methods— We reviewed existing evidence of the efficacy of interventions addressing blood pressure reduction, cholesterol lowering, antiplatelet/antithrombotic use, and smoking cessation and extracted relative risks for each intervention. From this, we developed a tool to estimate reductions in recurrent stroke risk, using bootstrapping and simulation methods. We also calculated a modified Global Outcome Score representing the proportion of potential benefit (relative risk reduction) achieved if all 4 individual risk factors were optimally controlled. We applied the tool to estimate stroke risk reduction among 275 participants with complete 12-month follow-up data from a recently published randomized trial of a healthcare delivery model that targeted multiple stroke risk factors. Results— The recurrent stroke risk tool was feasible to apply, yielding an estimated reduction in the relative risk of ischemic stroke of 0.36 in both the experimental and usual care trial arms. Global Outcome Score results suggest that participants in both arms likely averted, on average, 45% of recurrent stroke events that could possibly have been prevented through maximal implementation of interventions for all 4 individual risk factors. Conclusions— A stroke risk reduction tool facilitates estimation of the combined impact on vascular risk of improvements in multiple stroke risk factors and provides a summary outcome for studies testing alternative care models to prevent recurrent stroke. Registration— URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00861081.

scholarly journals Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults

Stroke ◽  
2017 ◽  
Vol 48 (7) ◽  
pp. 1744-1751 ◽  
Author(s):  
Annette Aigner ◽  
Ulrike Grittner ◽  
Arndt Rolfs ◽  
Bo Norrving ◽  
Bob Siegerink ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Stroke Risk ◽  
Stroke Risk Factors ◽  
Stroke In Young Adults ◽  
Stroke In Young

scholarly journals Reducing stroke burden through a targeted self-management intervention for reducing stroke risk factors in high-risk Ugandans: A protocol for a randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251662
Author(s):  
Mark Kaddumukasa ◽  
Josephine Najjuma ◽  
Scovia Nalugo Mbalinda ◽  
Martin N. Kaddumukasa ◽  
Jane Nakibuuka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomized Controlled Trial ◽  
Risk Reduction ◽  
Stroke Risk ◽  
Controlled Trial ◽  
Self Management ◽  
Primary Study ◽  
Management Intervention ◽  
Stroke Risk Factors ◽  
Randomized Controlled

Introduction Stroke burden is rapidly increasing globally. Modifiable risk factors offer an opportunity to intervene, and targeting hypertension is a key actionable target for stroke risk reduction in sub-Saharan Africa. This 3-site planned randomized controlled trial builds on promising preliminary data. Methods A total of 246 Ugandan adults will be recruited randomized to experimental intervention vs. enhanced treatment control. Intervention participants will receive six weekly group-format stroke risk reduction self-management training sessions, and the controls will receive information on cardiovascular risk. The primary study outcome is systolic B.P. measured at baseline, 13-week, 24 weeks (6 months). Secondary outcomes include other biological and behavioral stroke risk factors. Discussion The curriculum-guided self-management TargetEd MAnageMent Intervention (TEAM) program is anticipated to reduce the stroke burden in Uganda. Trial registration ClinicalTrials.gov identifier: NCT04685408, registered on 28 December 2020.

scholarly journals Global Outcome Assessment Life-long after stroke in young adults initiative—the GOAL initiative: study protocol and rationale of a multicentre retrospective individual patient data meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031144
Author(s):  
Merel Ekker ◽  
Mina Jacob ◽  
Myrna van Dongen ◽  
Karoliina Aarnio ◽  
Arunkar Annamalai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Secondary Prevention ◽  
Stroke Risk ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Stroke Patients ◽  
Young Stroke ◽  
Stroke In Young Adults ◽  
Stroke In Young

IntroductionWorldwide, 2 million patients aged 18–50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients.Methods and analysisThe Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18–50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence.Ethics and disseminationEthical approval for the GOAL study has already been obtained from the Medical Review Ethics Committee region Arnhem-Nijmegen. Additionally and when necessary, approval will also be obtained from national or local institutional review boards in the participating centres. When needed, a standardised data transfer agreement will be provided for participating centres. We plan dissemination of our results in peer-reviewed international scientific journals and through conference presentations. We expect that the results of this unique study will lead to better understanding of worldwide differences in risk factors, causes and outcome of young stroke patients.

Unpacking Violent Behavior in Young Adulthood: The Relative Importance of Hazardous Alcohol Use

2021 ◽  
pp. 088626052110441
Author(s):  
Siobhan Lawler ◽  
Lexine Stapinski ◽  
Maree Teesson ◽  
Katrina Prior ◽  
Miguel Basto-Pereira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Alcohol Use ◽  
Young Adulthood ◽  
Violent Behavior ◽  
Well Being ◽  
Self Report ◽  
Unique Contribution ◽  
Hazardous Alcohol Use ◽  
Hazardous Alcohol

Young adulthood is an important developmental period for investigating the nature of violent behavior. This study examines the unique contribution of alcohol use to violence perpetration among young adults in the Australian community, after accounting for the influence of sociodemographic, early life, trait, and well-being influences. Cross-sectional, self-report data was collected from 507 young adults aged 18-20 years in the Australian general community via an online survey. Sequential logistic regressions examined the relative and independent contribution of adverse childhood experiences (ACEs), impulsivity, psychological distress, and hazardous alcohol use to past-year violent behavior. Results show one in eight young adults aged 18-20 (13%) reported at least one act of violent behavior in the past year, primarily assault perpetrated against another person. Sequential logistic regression identified that after controlling for other risk factors, the number of ACEs reported and hazardous alcohol use were independently and positively associated with increased odds of reporting violent behavior in young adulthood. These findings demonstrate that ACEs and hazardous alcohol use are important, independent correlates of violent behavior in young adults. While preventing early adversity is key for reducing violence in the community, this evidence suggests that it is also important to target proximal causes such as hazardous alcohol use. Increasing early and widespread access to evidence-based, trauma-informed violence-prevention programs targeting risk factors across multiple settings is critical for reducing harm and supporting young people into healthy adulthood.

scholarly journals How Do Subjective Health Literacy Measures Work in Young Adults? Specifying “Online” or “Paper-Based” Forms Impacts Results

2020 ◽  
Vol 5 (1) ◽  
pp. 238146832092467
Author(s):  
Mary C. Politi ◽  
Courtney M. Goodwin ◽  
Kimberly A. Kaphingst ◽  
Xuechen Wang ◽  
Angela Fagerlin ◽  
...  
Keyword(s):  
Young Adults ◽  
Health Literacy ◽  
Health Information ◽  
Online Survey ◽  
Subjective Health ◽  
Self Report ◽  
Single Item ◽  
English Speaking ◽  
No Gold Standard ◽  
Electronic Health Information

Purpose. There is no gold-standard health literacy measure. The Single Item Literacy Screener (SILS) and Subjective Literacy Screener (SLS) ask people to self-report ability to understand health information. They were developed in older adults, before common use of electronic health information. This study explored whether the SILS and SLS related to objective literacy, numeracy, and comprehension among young adults, and whether specifying “online” or “paper-based” wording affected these relationships. Methods. Eligible individuals (18–35 years of age, English-speaking, US residents) from an online survey company were randomized to 1) original measures; 2) measures adding “paper-based” to describe health information/forms; or 3) measures adding “online” to describe health information/forms. We examined how each measure related to e-Health Literacy (eHEALS), subjective numeracy (SNS), objective numeracy (ONS), and comprehension of a short passage. Results. A total of 848/1342 respondents correctly answered attention-checks and were analyzed. The validated SILS related to comprehension ( P = 0.003), eHEALS ( P = 0.04), and ONS ( P < 0.001) but not SNS ( P = 0.44). When adding “paper-based,” SILS related to eHEALS ( P < 0.001) and ONS ( P = 0.003) but did not relate to comprehension ( P = 0.25) or SNS ( P = 0.35). When adding “online,” SILS related to comprehension ( P < 0.001), eHEALS ( P < 0.001), ONS ( P = 0.005), and SNS ( P = 0.03). The validated SLS related to comprehension ( P < 0.001), eHEALS ( P < 0.001), ONS ( P < 0.001), and SNS ( P < 0.001). When adding “paper-based,” the SLS only related to eHEALS ( P = <0.001) and comprehension ( P = 0.03) but did not relate to ONS ( P = 0.13) or SNS ( P = 0.33). When adding “online,” the SLS related to comprehension ( P < 0.001), eHEALS ( P < 0.001), and SNS ( P = 0.03) but not ONS ( P = 0.06). Conclusions. Young adults might interpret subjective health literacy measures differently when prompted to think about electronic or paper-based information. Researchers should consider clearer instructions or modified wording when using these measures in this population.

scholarly journals Measurement and Outcomes of the Perceived Risk of Stroke: A Review

2017 ◽  
Vol 41 (1) ◽  
pp. 134-154 ◽  
Author(s):  
Dawn M. Aycock ◽  
Patricia C. Clark ◽  
Semere Araya
Keyword(s):  
Risk Factors ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
Stroke Risk ◽  
Public Health Problem ◽  
Preventive Health ◽  
Healthy Lifestyles ◽  
Moderate Risk ◽  
Single Item ◽  
Preventive Health Behaviors

Stroke continues to be a public health problem, and risk perceptions are key to understanding people’s thoughts about stroke risk and their preventive health behaviors. This review identifies how the perceived risk of stroke has been measured and outcomes in terms of levels, predictors, accuracy, and intervention results. Sixteen studies were included. The perceived risk of stroke has primarily been assessed with single-item measures; no multi-item surveys were found. In general, people tend to perceive a low-moderate risk of stroke; the most common predictors of higher stroke risk perceptions were having risk factors for stroke (hypertension, diabetes) and a higher number of risk factors. However, inaccuracies were common; at least half of respondents underestimated/overestimated their risk. Few studies have examined whether interventions can improve the perceived risk of stroke. Strategies to improve stroke risk perceptions should be explored to determine whether accuracy can promote healthy lifestyles to reduce stroke risk.

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