The difficulty of studying race-ethnic stroke rehabilitation disparities in a community |
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Authors: | Lynda D Lisabeth Susan D Horn Nneka L Ifejika Emma Sais Michael Fuentes Xiaqing Jiang |
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Institution: | 1. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USAllisabet@umich.edu http://orcid.org/0000-0001-5539-5933 http://orcid.org/0000-0001-5539-5933;3. Departments of Biomedical Informatics and Population Health Sciences, University of Utah Medical School, Salt Lake City, UT, USA;4. Department of Neurology, McGovern Medical School at UTHealth, Houston, TX, USA;5. Stroke Program, University of Michigan Medical School, Ann Arbor, MI, USA;6. Corpus Christi Rehabilitation Hospital, Corpus Christi, TX, USA;7. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA |
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Abstract: | Objective: Minority populations have worse stroke outcomes compared with non-Hispanic whites (NHWs). One possible explanation for this disparity is differential allocation of stroke rehabilitation. We utilized a population-based stroke study to determine the feasibility of studying Mexican American-NHW differences in stroke rehabilitation in a population-based design including identification of community partners, development of standardized data collection instruments, and collection of pilot data. Methods: As part of the Brain Attack Surveillance in Corpus Christi project, we followed 48 patients for the first 90 days after stroke, and attempted to work with community partners to garner information on rehabilitation modalities used. With input from local occupational and physical therapists and speech language pathologists, we created data collection forms to capture rehabilitation activities and time spent on these activities and conducted a 3-month data collection pilot. Results: Of the 79 rehabilitation venues in the community, 63 (80%) agreed to participate. During the pilot, 545 data forms from 20 stroke patients were collected corresponding to ~18% of stroke patients. Forms were used by 13 partners during the pilot including 3 of 4 inpatient rehabilitation facilities, 4 of 13 skilled nursing facilities, 4 of 26 home health agencies, and 2 of 36 outpatient rehabilitation providers. Conclusions: Initial agreement from rehabilitation providers to participate in research was excellent, but completion of study related data collection forms was sub-optimal suggesting this approach is not feasible for a future population-based stroke rehabilitation study. Further methods to study post-stroke rehabilitation disparities in communities are needed. |
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Keywords: | Stroke rehabilitation ethnicity outcomes |
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