Summary: Few stroke
survivors meet recommended cardiovascular goals, particularly among
racial/ethnic minority populations, such as Black or Hispanic individuals, or
socioeconomically disadvantaged populations. This study's purpose is to determine
if a chronic care model-based, community health worker (CHW), advanced practice
clinician (APC; including nurse practitioners or physician assistants), and
physician team intervention improves risk factor control after stroke in a
safety-net setting (i.e., health care setting where all individuals receive care,
regardless of health insurance status or ability to pay).
Findings: In this randomized clinical trial that included 487 adults with
recent stroke or transient ischemic attack, there was no difference between
usual care and the multifaceted team-based intervention in blood pressure
control at 12 months.
This randomized
clinical trial of a complex multilevel, multimodal intervention did not find
vascular risk factor improvements beyond that of usual care; however, further
studies may consider testing the SUCCEED intervention with modifications to
enhance implementation and participant engagement.