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African American Stroke Survivors: More Caregiving Time, but Less Caregiving Burden.

ABSTRACT: BACKGROUND:Blacks have higher stroke incidence and experience greater poststroke disability than whites. To optimize care for stroke survivors, it is important to understand the amount of care that they receive and the implications for stroke caregivers. METHODS AND RESULTS:Data from 2 nationally representative, population-based studies, the NHATS (National Health and Aging Trends Study) linked to the NSOC (National Study of Caregiving), were used to identify elderly stroke survivors and their caregivers. We compared hours of care received and unmet activity need among the 581 white and 225 black stroke survivors. We then performed racial comparisons of positive and negative aspects of caregiving reported by caregivers of black and white stroke survivors. Black stroke survivors were more likely than white stroke survivors to have a caregiver (62.5% versus 49.7%; P<0.01) and received on average more hours of help per week (31.7 versus 20.5; P<0.01). There was little racial difference in unmet need for assistance. Caregivers of black stroke survivors reported more positive aspects of caregiving than caregivers of white stroke survivors (6.8 versus 6.0; P<0.01). There was no racial difference in negative aspects of caregiving, depression, or anxiety. CONCLUSIONS:Black stroke survivors received an average of ?11 more hours of care than white stroke survivors without substantial differences in unmet need. Despite providing more hours of care, caregivers of black stroke were more positive about their caregiver role than caregivers of white stroke survivors.

SUBMITTER: Skolarus LE

PROVIDER: S-EPMC5325085 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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African American Stroke Survivors: More Caregiving Time, but Less Caregiving Burden.

Skolarus Lesli E LE Freedman Vicki A VA Feng Chunyang C Burke James F JF

Circulation. Cardiovascular quality and outcomes 20170222 2

<h4>Background</h4>Blacks have higher stroke incidence and experience greater poststroke disability than whites. To optimize care for stroke survivors, it is important to understand the amount of care that they receive and the implications for stroke caregivers.<h4>Methods and results</h4>Data from 2 nationally representative, population-based studies, the NHATS (National Health and Aging Trends Study) linked to the NSOC (National Study of Caregiving), were used to identify elderly stroke surviv ...[more]

PMID: 28228451

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Project description:BackgroundSubstantial effort has been undertaken to improve the recruitment and retention of participants in stroke trials. African Americans are disproportionately under-represented in stroke clinical trials as well as clinical trials for other chronic disease conditions. To circumvent barriers to recruitment, clinical trial recruitment strategies used to recruit African Americans have focused on different aspects of community engagement.PurposeThis study examined a community-engaged, multi-phased tailored approach to recruiting African Americans with stroke. The recruitment approach described was designed to support the Community Based Intervention under Nurse Guidance after Stroke (CINGS) trial, part of the Wide Spectrum Investigation of Stroke Outcome Disparities on Multiple Levels (WISSDOM) Center established to explore stroke disparities.MethodsA multiple-phased recruitment approach was undertaken and involved a recruitment planning phase and a recruitment phase. The recruitment planning phase involved the use of focus groups designed to explore barriers and facilitators of stroke recovery. The active recruitment phase included multiple strategies with ongoing evaluation.ResultsInformation gained from focus groups offered insights into strategies critical to recruiting African Americans with stroke for behavioral research during the early recovery period. Strategies to enhance the identification of and recruitment of potential participants included use of: a) a hospital system stroke database, b) system-wide friendly visits/warm handoff approaches, c) electronic health record, d) associated external sites and e) protocol adjustments.ConclusionsDeveloping tailored approaches to curtail barriers to research participation is critical for increasing the probability of reaching African American study participant recruitment and retention goals. Research teams may require training in community-engagement research strategies essential for obtaining achieving target recruitment goals.

Project description:Purpose African American women with breast cancer have higher cancer-specific and overall mortality rates. Obesity is common among African American women and contributes to breast cancer progression and numerous chronic conditions. Weight loss interventions among breast cancer survivors positively affect weight, behavior, biomarkers, and psychosocial outcomes, yet few target African Americans. This article examines the effects of Moving Forward, a weight loss intervention for African American breast cancer survivors (AABCS) on weight, body composition, and behavior. Patients and Methods Early-stage (I-III) AABCS were randomly assigned to a 6-month interventionist-guided (n = 125) or self-guided (n = 121) weight loss program supporting behavioral changes to promote a 5% weight loss. Anthropometric, body composition, and behavioral data were collected at baseline, postintervention (6 months), and follow-up (12 months). Descriptive statistics and mixed models analyses assessed differences between groups over time. Results Mean (± standard deviation) age, and body mass index were 57.5 (± 10.1) years and 36.1 (± 6.2) kg/m2, respectively, and 82% had stage I or II breast cancer. Both groups lost weight. Mean and percentage of weight loss were greater in the guided versus self-guided group (at 6 months: 3.5 kg v 1.3kg; P < .001; 3.6% v 1.4%; P < .001, respectively; at 12 months: 2.7 kg v 1.6 kg; P < .05; 2.6% v 1.6%; P < .05, respectively); 44% in the guided group and 19% in the self-guided group met the 5% goal. Body composition and behavioral changes were also greater in the interventionist-guided group at both time points. Conclusion The study supports the efficacy of a community-based interventionist-guided weight loss program targeting AABCS. Although mean weight loss did not reach the targeted 5%, the mean loss of > 3% at 6 months is associated with improved health outcomes. Affordable, accessible health promotion programs represent a critical resource for AABCS.

Dataset Information

African American Stroke Survivors: More Caregiving Time, but Less Caregiving Burden.

Publications

African American Stroke Survivors: More Caregiving Time, but Less Caregiving Burden.

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