Online Program

Development of a culturally-tailored intervention to address care-seeking disparities in acute stroke treatment: A community-engaged approach

Monday, November 2, 2015 : 3:10 p.m. - 3:30 p.m.

Ellyn Leighton-Herrmann, PhD, Neurological Institute, Division of Stroke, Columbia University Medical Center, New York, NY
Amparo Abel-Bey, MPH, Neurology, Columbia University Medical Center, New York, NY
Alexandra DeSorbo, MPH, Neurological Institute, Stroke Division, Columbia University Medical Center (workplace) and Teachers College, Columbia University (school), New York, NY
Lenfis Valdez, MD, Neurology, Columbia University Medical Center, New York, NY
Madeleine Gordillo, MPA, Neurology, Columbia University Medical Center, New York, NY
Joseph Ravenell, MD, MS, Department of Population Health, New York University School of Medicine, New York, NY
Elizabeth Cohn, PhD, RN, College of Nursing and Public Health, Adelphi University, Garden City, NY
Michael Hecht, PhD, Communication Arts and Sciences, The Pennsylvania State University, University Park, PA
Gbenga Ogedegbe, MD, MS, MPH, FACP, Department of Population Health, New York University Langone Medical Center, New York, NY
Olajide Williams, MD MS, Neurological Institute, Stroke Division, Columbia University College of Physicians and Surgeons, New York, NY
Blacks are twice as likely as Whites to die from stroke and less likely to receive urgent time-dependent thrombolytic stroke treatment due to care seeking delays.

To address this, we developed a 12-minute, musical, culturally-tailored theatrical film, “The Gospel of Stroke”, targeting actionable stroke knowledge of urban, Black Churchgoers. We used a community-engaged approach to all components of film development, including cast selection. We were guided by a transdisciplinary Community Advisory Committee that included 3 stroke survivors, 3 faith leaders, 3 health professionals (a stroke expert and 2 MPH RAs), a nurse, a communication expert, and the film director. Separate focus groups with additional stroke survivors and caregivers identified themes that informed the initial story board, which was subsequently revised following the results of a Narrative Performance Scale (NPS) administered to survivors, caregivers, and faith leaders. The NPS enables testing of the narrative effects of an action-oriented health message on predicting behavioral intent.

We then evaluated the effect of the final film on behavioral intent to call 911 for stroke symptoms on 60 adult Black Churchgoers using the validated Stroke Action Test (STAT) in a pre-posttest format. STAT data were analyzed using repeated measures ANOVA and showed significant increase in intent to call 911 at immediate post-test (p<0.001), which remained significant at 3-months. Participant data also revealed positive findings in response to key constructs of the NPS (interest, realism, identification with characters).

Community-engaged development of a narrative communication intervention may provide an effective means to increase 911 calling for stroke.

Learning Areas:

Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related education
Social and behavioral sciences

Learning Objectives:
Discuss a community-engaged approach to intervention development Identify components of a community-engaged design

Keyword(s): Community-Based Research (CBPR), Strokes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Officer of Research at Columbia University Medical Center. As a research faculty member, I oversee the implementation of the study being presented and assist with design and analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.