Qualitative Analysis of the Post-Stroke Continuum Among African Stroke Survivors in Alabama

This proposal seeks to improve the investigators' post-stroke TOC process through developing an innovative, patient informed and guided solution aimed at addressing the investigators' deep south African American population within the UAB system. The investigators will engage participants in both urban and rural Alabama through informational interviews and work to find common themes to address so that future interventions are useful to their unique needs and desires. This goes beyond simply identifying barriers and endeavors to discovering solutions.

Study Overview

• Status: Withdrawn
• Conditions: Stroke; Caregiver Burden; Patient Satisfaction; Disability Physical
• Intervention / Treatment: Other: Informational Interview; Other: Focus Group

• Study Type: Observational

Contacts and Locations

• Study Contact: Name: Amber N Clark, MD; Phone Number: 205-934-8526; Email: amberclark@uabmc.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

We will screen 60-100 individuals with the goal of enrolling a total of 20 AA stroke survivors +/- their identified caregivers. Individuals will be recruited from within the UAB Health System from the acute care neurology stroke service and the PI's stroke recovery clinic. Participants will be separated into 3 groups. Group A will include n=10 participants that are less than 1 year out from their most recent stroke. Group B will include n=10 participants that are greater than 1 year out from their most recent stroke. Group C will include the participants' identified caregivers. Having an available caregiver is preferred but is not required. Therefore, a goal of at least 10 caregivers is set.

Description

Inclusion Criteria:

1. African American
2. Aged 40 years and older
3. Required home health therapy, outpatient therapy, skilled nursing facility or inpatient rehabilitation
4. Alabama Resident
5. Fluent in English
6. Stroke confirmed by advanced imaging (CT, MRI)
7. Zoom capability (participants can either have video conference ability or can call into Zoom line)
8. Caregivers must be identified by patients as providing a significant portion of care and/or be able to articulate their role as a caregiver

Exclusion Criteria:

1. Did not require home health therapy, outpatient therapy or inpatient rehabilitation
2. Long term residents of skilled nursing facility
3. Severe aphasia
4. Severe cognitive impairments

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Stroke Survivors <1 year; Group A will include participants that are less than 1 year out from their most recent stroke.	Other: Informational Interview; Interview topics will fall in the broad categories of assessing medical knowledge and understanding of stroke, knowledge of medical and community resources, understanding and experience of post-stroke rehabilitation barriers faced upon reintegrating back home and ability to continue management of stroke diagnosis and suggestions for improvement.
Stroke Survivors >1 year; Group B will include participants that are greater than 1 year out from their most recent	Other: Informational Interview; Interview topics will fall in the broad categories of assessing medical knowledge and understanding of stroke, knowledge of medical and community resources, understanding and experience of post-stroke rehabilitation barriers faced upon reintegrating back home and ability to continue management of stroke diagnosis and suggestions for improvement.
Caregivers; Group C will include participants' identified caregivers.	Other: Focus Group; Focus group topics will fall into the same broad categories as the informational interviews, however will be asked from a caregiver's perspective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of recruitment and retention	The investigators will screen 60-100 individuals with the goal of enrolling a total of 20 AA (African American) stroke survivors +/- their identified caregivers. Historically, there has been low recruitment and retention rates for AAs. The investigators plan to over-recruit in order to account for this phenomenon and track our success/failure rates with percent retained vs recruited.	July 1,2022-January 20, 2023
Ability to use Zoom platform	The Zoom platform is becoming a more popular avenue to conduct qualitative interviews for research purposes among researchers and participants. The investigators will evaluate if this reported phenomenon is reproducible within this particular research cohort. Success will measured by a 50% or greater completion of interview and the ability to successfully connect to the zoom platform either via smart device or telephone dial in. The investigators will also document any technical difficulties that are encountered from either the interviewer's standpoint or the participant's standpoint.	July 1,2022-January 20, 2023
Validity of questions asked to arrive at the themes that will appropriately inform the basis of this proposal	We will extract data from transcriptions of participants' Zoom interviews and perform thematic analysis	February 2023-May 2023

Collaborators and Investigators

• Sponsor: University of Alabama at Birmingham

Study record dates

Study Major Dates

• Study Start (Estimated): February 1, 2023
• Primary Completion (Actual): February 28, 2023
• Study Completion (Actual): February 28, 2023

Study Registration Dates

• First Submitted: March 30, 2022
• First Submitted That Met QC Criteria: April 21, 2022
• First Posted (Actual): April 28, 2022

Study Record Updates

• Last Update Posted (Actual): July 18, 2023
• Last Update Submitted That Met QC Criteria: July 17, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Keywords: Rehabilitation; Post-Stroke Rehabilitation Continuum
• Additional Relevant MeSH Terms: Behavioral Symptoms; Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stress, Psychological; Stroke; Caregiver Burden
• Other Study ID Numbers: 300009035

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No