Friday, June 21, 2024
6/21/2024
Abstract For a quarter of a century, the Brain Attack Surveillance in Corpus Christi (BASIC) Project has continued to assemble a cohort of over 11,000 persons with stroke in a biethnic Texas community to study health equity and the social determinants of stroke and stroke outcomes. This population-based project focuses on Mexican American persons, the largest sub-group of Latinx, the United States’ largest minority population. In the newest cycle, BASIC will continue to monitor trends and ethnic disparities in stroke incidence, recurrence, 90-day outcomes (neurologic, functional, cognitive, and quality of life) and all-cause mortality. Because of previous work suggesting a rising incidence in those 45-59 years of age, for the first time, BASIC will expand stroke surveillance and outcome assessments to include those 35-44 years of age, where preliminary data suggests that there is considerable stroke burden. Novel and innovative for this cycle of BASIC is a new mixed methods focus on risk and resilience mechanisms among Mexican American stroke survivors to determine factors that lead to better stroke outcome. Utilizing a modified Reserve Capacity Model, we will investigate barriers and facilitators to favorable stroke outcomes and utilization of post-stroke healthcare among Mexican American stroke survivors. The Reserve Capacity Model is a framework to examine the role of psychosocial factors in health and health disparities including sociocultural and other resilience factors (e.g., reserve capacity resources) that may be associated with better health outcomes. We will adapt this model to the stroke context and to the unique cultural features of the Mexican American study community. This will be paired with a rigorous qualitative investigation of available resources and unmet needs for favorable stroke outcomes among Mexican American stroke survivors, including those 35-44 years of age. The previous cycle of BASIC saw the beginning of an exciting linkage of our population-based study with administrative data creating a unique “big data” resource. We now propose an innovative expansion of this effort and for the first time in addition to Medicare data, we will link BASIC data to Medicare Advantage, Medicare Part D and Medicaid data. These data linkages will be used to identify barriers and facilitators to post-stroke healthcare utilization, including emergency department visits, readmissions, use of long-term care, primary care visits, mental health visits and use of inpatient rehabilitation. Together, this next BASIC cycle will continue to monitor emerging stroke trends and ethnic disparities while exploring several new avenues directed at uncovering specific targets to improve Mexican American stroke health equity.
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