Abstract P109: Racial/Ethnic Disparities in Post-Stroke Disability: A Focus on Outcome Measures

Abstract

Background and Purpose: Several studies suggest that racial/ethnic minority groups experience worse disability across the course of stroke recovery. However, there is little consistency in the measurement of stroke outcomes, which may contribute to some inconclusive evidence of racial/ethnic disparities in post-stroke disability. The objective of the current review is to examine how stroke outcomes are measured to identify racial/ethnic disparities in disability and functioning among stroke survivors in the US. Methods: A review of the literature was conducted to identify outcome measures used in racial/ethnic disparities in post-stroke disability literature, use the International Classification of Functioning, Disability, and Health (ICF) model as a frame of reference for mapping the contents of the identified measures, and evaluate the time points of measured outcomes and racial/ethnic representation. Articles published between January 2001 and July 2017 were identified with our search criteria through Scopus, PubMed, CINAHL, and PsycINFO according to predefined inclusion criteria. Results: One hundred and ninety-four articles met inclusion criteria for full-text review and 41 articles were included in the final review. Although we found evidence of outcome measure content aligning with all ICF domains, little research has examined contextual factors in post-stroke disability disparities research. Additionally, we discovered the outcome measures are conducted across stroke recovery trajectories including pre-stroke, acute stroke, early recovery (≤90 days), and long-term (>90 days) but little consistency in outcome measure use was discovered. African American and Hispanic populations were assessed most frequently and minimal studies examined disparities among other minority populations comprising the US (i.e., Asian, Native Hawaiian or Other Pacific Islander, American Indian or Alaska Native). Conclusions: A variety of outcome measures have been used to assess disparities in disability across the course of stroke recovery. Yet, the lack of consistency in what outcomes are measured and when specific outcomes are assessed may contribute to mixed findings in the racial/ethnic disparities literature. Additional concerns include the lack of evidence on validity of outcome measures among racial/ethnic minority populations, the lack of representation among all racial/ethnic populations comprising the US, and minimal emphasis placed on the disparities in personal and environmental factors that contribute to disability. This review sheds light on the need for additional disparities in post-stroke disability research focusing on contextual factors and greater representation among less studied populations in the US.