Kronish 2014.
Methods |
Study design: RCT Sampling frame: stroke survivors receiving Visiting Nurse care or clinic‐based care, and community‐dwelling residents Sampling method: record of diagnosis of stroke or TIA in Visiting Nurse or clinic records, or community residents with self report of stroke. These were randomly assigned to treatment or wait‐list control Description of the community coalition: The East and Central Harlem Health Outcomes Community Action Board was a community‐academic partnership with a history of working together for a decade or longer. Members included community residents, stroke survivors, and community educators. Little description was provided about coalition structure, processes, or partner members beyond affiliations of study authors with Mt Sinai School of Medicine and Columbia University Medical Center. Community residents were involved in the design of PRAISE, a tailored version of Stanford University's Chronic Disease Self Management Program, and implementation of the intervention as peer educators |
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Participants |
Communities: Harlem and Bronx areas of New York Country: USA Ages included in assessment: adults Reasons provided for selection of intervention community: minority populations — African American and Latino — at high risk for recurrent stroke Intervention community (population size): Harlem and Bronx, population size not reported Comparison community (population size): Harlem and Bronx, population size not reported |
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Interventions |
Name of intervention: PRAISE (Prevent Recurrence of All Inner‐City Strokes Through Education) Theory: Appreciative Inquiry (Suchman AL 2004) Aim: "to increase the proportion of stroke and TIA survivors who achieve control of B/P, lipids, and adherence to antithrombotic medication" Description of costs and resources: no cost data provided. Study authors did state that a week‐long training course was provided to peer educators, and that they were reimbursed for providing the 6 intervention workshops (amount not disclosed) Components of the intervention: 6 workshops on stroke and risk prevention related to B/P, lipids, and medication Start date: 2009 Duration: 6 weeks with one 90‐minute session per week |
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Outcomes |
Outcomes and measures (follow‐up months): control of 3 stroke risk factors: B/P, lipids (LDL), and medication adherence Date (year) of pre and post measurements: Between 2009 and 2012, study participants were recruited, baseline measurements were taken, and participants were randomly assigned to treatment or wait‐list control. Intervention duration was 6 weeks. Follow‐up measurements were taken at 6 months |
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Notes | 301 allocated to peer education intervention 299 allocated to wait‐list control 85% f/u at 6 months Study authors state that more than half of the treatment group participated in at least 50% of the program workshops |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | After baseline measurements, participants were randomly assigned to treatment or wait‐list control |
Allocation concealment (selection bias) | Low risk | Allocation concealed by blinded third party |
Baseline outcome measurement similar | Low risk | No differences noted in baseline outcome measures |
Baseline characteristics similar | Low risk | Baseline characteristics similar |
Blinding of outcome assessment (detection bias) All outcomes | High risk | Blinding not reported |
Incomplete outcome data (attrition bias) All outcomes | Low risk | 85% follow‐up at 6‐month measurement |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding not reported |
Protection against contamination | Unclear risk | Unlikely but not described |
Selective reporting (reporting bias) | Low risk | Primary outcomes were reported |