An Intersectional Exploration: Experiences of Stroke Prevention in Middle-Aged and Older Arab Muslim Immigrant Women in Canada

Background Arab immigrants have increasing rates of stroke and uncontrolled stroke risk factors coupled with minimal resources for stroke prevention. Purpose This article describes the results of an interpretive descriptive study about Arab immigrant women’s experiences of practicing stroke prevention. We use an intersectionality approach to discuss some of the factors that influenced women’s ability to manage their health. Methods Sixteen middle-aged and older Arab Muslim immigrant women were recruited between 2015 and 2016 from two religious centers in an urban Canadian center. Women were between the ages of 45 and 75 years, were living in the community, and had a combination of stroke risk factors. Semi-structured interviews lasting 2–3 h were conducted in Arabic by the primary bilingual researcher. Data analysis was completed in Arabic, with final themes and exemplars translated to English with the support of a certified translator. Results Study themes include relating life stressors to physical health, pursuing knowledge in the dark, negotiating medication and treatment options, making an effort to eat healthy and be active, and identifying triple ingredients for empowerment. Conclusion Economic status, access to transportation, language fluency, life stressors, and personal coping strategies influenced Arab women’s ability to manage personal health.

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Management of Stroke Risk Factors During the Process of Rehabilitation: Secondary Stroke Prevention

Physical Medicine and Rehabilitation Clinics of North America ◽

10.1016/s1047-9651(18)30166-9 ◽

1999 ◽

Vol 10 (4) ◽

pp. 839-856 ◽

Cited By ~ 3

Author(s):

Eugen M. Halar

Keyword(s):

Risk Factors ◽

Stroke Prevention ◽

Stroke Risk ◽

Secondary Stroke Prevention ◽

Stroke Risk Factors

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Comparison of Stroke Risk Factors between Middle-aged and Elderly Patients

Journal of Korean Gerontological Nursing ◽

10.17079/jkgn.2017.19.1.13 ◽

2017 ◽

Vol 19 (1) ◽

pp. 13-27 ◽

Cited By ~ 2

Author(s):

Sujin Seok ◽

Jia Lee

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Stroke Risk ◽

Middle Aged ◽

Stroke Risk Factors

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A Pharmacist-Led Stroke Education and Screening Program for Community-Dwelling Older Adults

The Senior Care Pharmacist ◽

10.4140/tcp.n.2019.127 ◽

2019 ◽

Vol 34 (2) ◽

pp. 127-142

Author(s):

Marketa Marvanova ◽

Paul Jacob Henkel

Keyword(s):

Risk Factors ◽

Health Status ◽

Stroke Prevention ◽

Stroke Risk ◽

Community Dwelling ◽

Warning Signs ◽

Secondary Stroke Prevention ◽

Stroke Risk Factors ◽

Stroke Knowledge ◽

Study Questionnaire

OBJECTIVES: To deliver a pharmacist-led education and screening for community-dwelling residents, assess the effect of this initiative on knowledge of stroke risk factors and warning signs, and evaluate the stroke-knowledge and risk-assessment questionnaire as a tool to identify stroke-related health status and identify need(s) for specific clinical intervention(s) to decrease risk. DESIGN: The 70-minute-long event comprised: brief introduction/informed consent, baseline assessment of stroke knowledge, completion of study questionnaire, single blood pressure and heart rate readings, presentation, question-and-answer session, postsurvey questionnaire items. SETTING: Four faith-based institutions in the Midwest. PARTICIPANTS: Independent community-dwelling adults 18 years of age and older (N = 97), 89.7% 60 years of age and older. INTERVENTIONS: Thirty-minute presentation followed by question-and-answer session on ischemic stroke. Screening for primary and secondary stroke-prevention status using study questionnaire and vital signs. MAIN OUTCOME MEASURE(S): Stroke knowledge regarding modifiable stroke-risk factors and acute stroke-warning signs, individual primary/secondary stroke-prevention status. RESULTS: Postintervention, mean number of modifiable stroke risk factors (2.6 ± 0.8) and warning signs (2.6 ± 0.8) named improved from preintervention (P < 0.001) including for most subgroups (i.e., self-reported hypertension, atrial fibrillation [AF], or high number of personal risk factors). Needs for improved primary/secondary prevention were identified for blood-measure control and antilipidemic therapy. No disparity was observed regarding thrombotic therapy in participants with AF. CONCLUSION: The program was resource-efficient, involved student pharmacists, improved immediate stroke-related knowledge of participants including those with increased risk(s) of stroke, and demonstrated value for evaluating stroke-related health status and identifying need for primary and secondary stroke prevention.

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Increased Prevalence of Stroke Risk Factors Among Middle-Aged and Minority Women

Journal of Obstetric Gynecologic & Neonatal Nursing ◽

10.1111/j.1552-6909.2010.01126_2.x ◽

2010 ◽

Vol 39 ◽

pp. S100-S101

Author(s):

Carolyn Strimike

Keyword(s):

Risk Factors ◽

Stroke Risk ◽

Minority Women ◽

Middle Aged ◽

Stroke Risk Factors

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Abstract P886: Differences in Medication Utilization for Secondary Stroke Prevention Between Ghanaian Stroke Patients and Stroke Patients in the United States

Stroke ◽

10.1161/str.52.suppl_1.p886 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Esther Olasoji ◽

FRED S SARFO ◽

Alexis Simpkins

Keyword(s):

Risk Factors ◽

Stroke Prevention ◽

Stroke Risk ◽

The United States ◽

Rural Setting ◽

Secondary Stroke Prevention ◽

Stroke Patients ◽

Stroke Risk Factors ◽

Medication Utilization ◽

Oral Agents

Introduction: Optimization of secondary stroke prevention is an essential part of stroke care globally. We sought to assess differences in medication utilization between African Americans (AA), Non-Hispanic Whites (NW), and Ghanaians in addition to effects related to location of residence (rural versus urban). Methods: Data from the UFHealth institutional stroke database and the Kumasi, Ghana Stroke Survivors Registry between 01/2014 and 11/2019 provided a dataset of adult patients diagnosed with stroke from both locations. Multivariate regression analysis identified differences between country of origin, race, patient demographics, location of residence, stroke risk factors, and clinical management following stroke. Results: Of the 5519 patients studied, the median age was 66 (IQR 45 - 87), 16% were AA, 19% Ghanaian, 66% NW, and 51% were male. After controlling for age, sex, stroke type, and stroke risk factors, we found that in comparison to the AA and NW, patients from Ghana were more likely to be prescribed angiotensin converting enzyme (ACE) inhibitors (OR 1.42, 1.05-1.93 95% CI), angiotensin receptor blockers (ARB) (OR 18.36, 13.08-25.78 95% CI), calcium channel blockers (CCB) (OR 8.35, 6.30-11.08 95% CI), statin (OR 3.26, 2.26-4.59 95% CI), anti-diabetic oral agents (OR 7.18, 4.21-12.27 95% CI); less likely to be prescribed anticoagulant (OR 0.22, 0.12-0.40 95% CI), beta blockers (BB) (OR 0.15, 0.11-0.21 95% CI), and insulin (OR 0.11, 0.06-0.20 95% CI). In comparison to AA, Ghanaians were more likely to be prescribed statin (OR 3.06, 1.93-4.86 95% CI), ARBs (OR 22.87, 13.85-37.79 95% CI), CCBs (OR 5.83, 3.94-8.62 95% CI), anti-diabetic oral agents (OR 8.89, 4.25-18.59 95% CI); less likely to live in an urban vs rural setting (OR 0.64, 0.46-0.89 95% CI), be prescribed anticoagulant (OR 0.28, 0.14-0.55 95% CI), BBs (OR 0.13, 0.0.09-0.19 95% CI), and insulin (OR 0.11, 0.05-0.23 95% CI). Conclusion: In conclusion, we found significant differences in the prevalence of medications prescribed for stroke prevention between Ghana and the U.S. Further research is needed to determine if these differences result in consequential differences in stroke reoccurrence between these populations.

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Abstract W P423: Women Perceive Differences in Stroke Prevention Care Based on their Primary Care Physician’s Specialty

Stroke ◽

10.1161/str.46.suppl_1.wp423 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Hanna King ◽

Clotilde Balucani ◽

Dimitre Stefanov ◽

Mary Rosser ◽

Brian Tark ◽

...

Keyword(s):

Risk Factors ◽

Stroke Prevention ◽

Stroke Risk ◽

Demographic Variables ◽

Categorical Variables ◽

Exact Test ◽

Stroke Risk Factors ◽

Patient Demographics ◽

Stroke Prevalence ◽

Women’S Perceptions

BACKGROUND: Women have higher lifetime risk of stroke than men. Many women rely solely on their Ob/Gyn as their PCP; however, there are no data on women’s perceptions of stroke prevention (SP) care by their Ob/Gyn. OBJECTIVES: to explore (1) women’s perceptions of SP based on their PCP’s specialty; (2) if ethnicity or age influenced women’s selection of PCP specialty; and (3) women’s awareness of stroke prevalence and preferences for which type of PCP address their stroke risk factors. METHODS: We administered surveys to 224 women at Ob/Gyn (n = 132) and PCP (n = 94) clinics in Brooklyn, NY. Surveys consisted of 16 questions on patient demographics, awareness of stroke prevalence, stroke risk factors, specialties of physicians they regularly visit, preferences for SP and SP care received. Kruskall-Wallis and Mann-Whitney tests were used to compare ordinal variables. Fisher’s exact test was used for categorical variables. RESULTS: We found a difference (p < 0.0001) in the mean age (but not in other demographic variables) of women who only visited an Ob/Gyn (30.0yrs±6.0) compared with those who visited an Ob/Gyn and another PCP (44.2±15.9) and those who visited at least one non-Ob/Gyn PCP (55.7±17.7). Women recalled: BP measurement by Ob/Gyn in 75% vs. 95% by other PCP (p<0.001); cholesterol measurement by Ob/Gyn 24% vs. other PCP 59% (p<0.0001); diabetes screening (p = 0.17) and weight measurement (p = 1.0) were similar. Awareness of stroke prevalence differed (p = 0.04) among women visiting only an Ob/Gyn (mean 0.5±0.7 correct answers), women visiting Ob/Gyn and at least one other PCP (1.0±0.8) and women visiting only a non-Ob/Gyn PCP (1.2±0.8). Women reported a greater preference for addressing SP with their non-Ob/Gyn PCP (73%) vs. their Ob/Gyn (2%) vs. no preference (26%). CONCLUSIONS: Ob/Gyn are perceived to provide less SP care than non-Ob/Gyn PCP. However, most women would prefer to address SP with their non-Ob/Gyn PCP. Women who visit only an Ob/Gyn and no other PCP were younger and less aware of stroke prevalence than women who visited other PCP. This surrogate approach to actual SP care evaluation suggests a need for assessing Ob/Gyn practices in SP.

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Abstract 3388: Awareness and Risk for Stroke among Community Living Middle-Aged Adults in Korea

Stroke ◽

10.1161/str.43.suppl_1.a3388 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Kyoung Nam ◽

Hee-Young Song

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Body Weight ◽

Blood Sugar ◽

Risk Score ◽

Stroke Risk ◽

Community Living ◽

Middle Aged ◽

Stroke Risk Factors ◽

Middle Aged Adults

Background Control of stroke risk factors, in particular, hypertension and unhealthy life styles such as high fat diet, and inactivity which are modifiable have been focused for primary prevention of stroke. Greater awareness for stroke may promote individual to involve preventive activities. In Korea, relatively little research has been done on the awareness and risk for stroke among community living adults. We investigated awareness for stroke, calculated stroke risk score using the Framingham stroke risk score profile, and examined the relationship among awareness for stroke, blood pressure(BP), body weight, blood sugar, cholesterol and stroke risk score among middle-aged adults in Korea. Methods A total of 99 participants ( 3 9 men, 60 women) aged 47.0 years old were recruited in an urban area and were interviewed by researchers using a structured questionnaire including stroke risk factors. Awareness for stroke was assessed with baseline knowledge on stroke risk factors, symptoms, and treatment; and recognition on important indicators such as BP, body weight, blood sugar and cholesterol. Stroke risk was determined by applying the Framingham stroke risk profile. Data were analyzed by descriptive statistics, t-test, and Pearson’s correlation using PASW statistics 18.0. Results Participants answered more than 3 stroke warning signs out of 5, although most participants did not know if their BP, body weight, blood sugar, and cholesterol were within normal limits. Scores of stroke risk determined by Framingham stroke risk profile showed significant difference between men and women (3.85±2.35 vs. 2.52±.06) (t=2.968, p=.004). Only systolic blood pressure was related with stroke risk in men(r=.537, p=.002), while blood sugar(r=.497, p=.005), systolic(r=.705, p <.001) and diastolic blood pressure(r=.557, p<.001) were related with stroke risk in women. The negative correlation between awareness for stroke and stroke risk was found in women(r=-.303, p=.021). Conclusions There is need to improve the awareness of stroke among community living middle-aged adults by providing more targeted information on stroke risk factors and their contribution to stroke prevention.Further studies are warranted to refine predictive factors for the risk of stroke, regarding gender difference in relationship between stroke risk score and BP, body weight, blood sugar and cholesterol which are important indicators for major illness related to stroke.

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An Examination of Stroke-Related Knowledge in Male Stroke Survivors Living in the South Carolina Stroke Belt

American Journal of Men s Health ◽

10.1177/1557988314531038 ◽

2014 ◽

Vol 8 (6) ◽

pp. 532-537 ◽

Cited By ~ 1

Author(s):

Charles Ellis

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Risk Factor ◽

Racial Differences ◽

Stroke Prevention ◽

Stroke Risk ◽

Stroke Survivors ◽

Stroke Risk Factor ◽

Stroke Risk Factors ◽

Stroke Knowledge

Racial differences have been observed in stroke-related knowledge and knowledge of specific stroke risk factors and stroke prevention practices. Using data from 134 male stroke survivors, racial differences in overall knowledge, risk factor knowledge, and stroke prevention practices were examined using the Stroke Knowledge Test. Knowledge that diabetes doubles ones risk of stroke was present in 48% of the participants, while knowledge of aspirin in the prevention of stroke by stopping blood clot formation was reported in 83% of the participants. Findings indicate participants were knowledgeable that obesity increased risk of stroke (71%) and high blood pressure was the most important stroke risk factor (70%). Participants indicated knowledge that diet, exercise, and controlling blood pressure and cholesterol reduces risk of stroke (86%). In regression models, there were no significant race differences in overall stroke knowledge or the odds of knowledge of information related to stroke risk factors and stroke prevention practices after adjusting for age, education, and marital status. Although stroke-related knowledge did not differ by race, stroke survivors exhibited gaps in stroke knowledge particularly of knowledge of common risk factors. These factors should be considered in approaches to improve stroke-related knowledge in all stroke survivors.

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Abstract W P173: Providing Education on Primary Risk Factors for Stroke to African American Females 18 Years and Older

Stroke ◽

10.1161/str.46.suppl_1.wp173 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Maureen Mathews ◽

David Wang

Keyword(s):

Risk Factors ◽

African American ◽

Stroke Risk ◽

Public Awareness ◽

African American Females ◽

Sources Of Information ◽

Middle Aged ◽

Multiple Sources ◽

Post Intervention ◽

Stroke Risk Factors

Stroke is fourth leading cause of death and primary contributor to adult disability in US. Mortality has declined in past 10 years, but prevalence has increased; indicating public risk factor education should be a higher priority. Education is especially important for high-risk individuals Methods: this project assessed knowledge and motivation for behavioral changes in African American females (AAF) >18 years of age before/after a presentation regarding stroke risk factors. A community-based program utilizing video and group discussions was developed using AHA/ASA/NSA resources. A post intervention tool included demographic information and participants’ knowledge regarding stroke symptoms/risk factors. Results are used to plan future education programs Results: fifty-one AAF attended a presentation and completed a survey. Participants were divided into three groups for analysis: 18-35 yo, young; 36-55 yo, middle-aged; and 56+ yo, older. There were 12(24%) young participants, 19 (37.2 %)middle-aged participants, and 20 (39.2%) were older. Prior to educational sessions, participants reported having learned about stroke primarily from television, 28 (55%); doctor, 28 (55%); and family, 25 (50%). Participants identified stroke risk factors as hypertension, 16 (31%); smoking, 10 (20%); obesity, 10 (20%); diabetes, 6 (12%); atrial fibrillation, 3 (6%); and hyperlipidemia, 2 (4%). Participants plan to reduce risk factors through exercise, 17 (33%); diet,11 (22%); and medications, 9 (18%). Forty-four (86%) of participants would call 911 for suspected stroke. The FAST acronym was used to educate participants on signs/symptoms of stroke. The post education survey showed majority of participants were able to name at least one/three signs for stroke, including facial droop, 31 (61%); arm/leg weakness, 28 (55%); and speech changes, 28 (55%). Conclusion: participant responses support literature indicating multiple sources of information are necessary to increase/improve public awareness of stroke risk factors/symptoms. However, ongoing education needed for public to retain knowledge of stroke. Considering cultural differences in populations when designing stroke educational programs is important to utilize the most effective media.

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