Abstract TP85: Neighborhood Built Environment May Not Influence Reintegration to Normal Living Post-Stroke

Abstract

Introduction: Reintegration to normal living post-stroke is important to foster peer support and recovery. Reintegration may be facilitated through neighborhood resources and out-of-home facilities. Methods: The Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) intervention randomized stroke survivors to skills-based intervention or usual care with the goal of improving post-stroke blood pressure. Three domains of reintegration to normal living (RINL) through daily functioning (community mobility, recreational, and social activity participation) at 12-months post-stroke were evaluated. Participants’ addresses were linked to census tract area density of community resources from the National Neighborhood Data Archive. Recreational, arts, entertainment, religious, social and civil, and personal care resources were assessed in separate linear regression models for related RINL domains first unadjusted and then adjusting for age, race-ethnicity, gender, education, insurance status, number of identified alters, intervention status, and stroke severity. Loss-to-follow-up was accounted for using inverse probability weights. Results: Of the 546 DESERVE participants, 342 responded to 12-month RINL elements. Respondents were 64.9 years on average (SD=12.1) with a median NIHSS of 2.0 (IQR=4.0). The median level of RINL for each domain was the maximum (10). Comparing high to low, resource densities were not associated with any of the RINL domains in unadjusted or adjusted models ( Figure ). Conclusion: In our novel exploration of neighborhood resources and RINL, the density of these built environment resources did not seem to influence individuals’ reintegration to normal living 12-months post-stroke. However, the metric of reintegration had a ceiling effect; future evaluations may need to consider different tools to better identify more sensitive metrics of reintegration post-stroke.