Abstract
Importance: Despite prevention strategies with proven efficacy, recurrent stroke rates, especially in minority populations, remain high. Mobilizing stroke patients’ social networks on risk reduction goals may optimize secondary prevention efforts. Families/Friends Understanding Risk Reduction Through Educational Reinforcement (FURRThER) is a culturally-tailored, social network-based intervention facilitated by an interactive web portal and targeted at management of vascular risk factors. Objective/ outcome: To identify a signal of efficacy for the FURRThER intervention by evaluating changes in participants’ mean systolic blood pressure. Methods: Pilot study with pre-post design and 3 month follow-up. Participants are multi-ethnic patients with mild/moderate stroke prospectively enrolled in hospital. Participants (patients and family/friends) were CVD risk assessed (AHA Life’s Simple 7 survey). Family/friends networks’ identified risk reduction goals and worked together to reinforce positive behavior. Participants received follow-up call at 72 hours and via FURRThER web portal/phone weekly for 3 months. Portal communication included messages of encouragement, resources, reminders about selected goals and medical appointments. Results: The pilot recruited 13 family/friend networks in hospital (13 patients, 17 family/friends). Patients were 70% male; 61 + 8 yrs; 8% Hispanic, 15% black and 8% Asian. Average BP at baseline was 131/76 mmHg; at follow-up 123/72(p=0.04). Family/friend networks mostly choose to work together on diet and physical activity.. Some goals were network based (e.g., grocery shopping together). Medication adherence was reinforced with all groups. The pilot also identified significantly high unrecognized HTN in 30% of family/friends. Summary: FURRThER pilot demonstrated an 8mmHg decrease in SBP in patients. Involving family/friends allowed for the identification of risk factors within networks and for discussion of support/lifestyle modification towards risk reduction. Family/friend groups reported they continued to engage in lifestyle changes agreed upon in the goal setting session. A multisite, phase 2b/3A trial is needed to demonstrate efficacy.
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