{"id":{"repo_id":"tdl","oai_identifier":"oai:tdl-ir.tdl.org:11274/17103"},"canonical_url":"https://search.dev.ndltd.org/etd/tdl/oai:tdl-ir.tdl.org:11274/17103","repository":{"repo_id":"tdl","name":"Texas Digital Library","base_url":"https://tdl-ir.tdl.org/server/oai/request"},"display":{"title":"Examining the relationship between American Heart Association stroke prevention strategies and the incidence of recurrent stroke in large urban stroke prevention and neurology clinics","abstract":"Stroke remains a leading cause of death and disability, imposing a significant burden on survivors and healthcare systems. Despite established guidelines by the American Heart Association/American Stroke Association, adherence to secondary stroke prevention strategies remains a challenge. This study examined the relationship between American Heart Association stroke prevention strategies, medication adherence, and recurrent stroke and the differences in implementing stroke prevention strategies based on clinic type, age, sex, gender, and insurance type. The study found no direct association between the implementation of stroke prevention strategies, medication adherence, and recurrent stroke. Findings showed that specialized stroke prevention clinics (SSC) were more effective in implementing strategies, particularly in dietary education, physical activity counseling, and sleep apnea screening, compared to the Neurology clinics, highlighting the value of specialized care in promoting comprehensive stroke prevention. Furthermore, lack of insurance was associated with lower implementation of prevention strategies, aligning with broader concerns regarding healthcare access for uninsured populations. Limitations include a small number of participants with recurrent stroke and other unmeasured confounders. Findings emphasize the need for dedicated stroke prevention clinics, improved patient education, greater adherence to guideline-based care, and the establishment of universal health insurance to improve access to care and reduce health disparities. Future research should explore interventions to improve long-term stroke prevention, particularly among high-risk populations.","abstract_html":"Stroke remains a leading cause of death and disability, imposing a significant burden on survivors and healthcare systems. Despite established guidelines by the American Heart Association/American Stroke Association, adherence to secondary stroke prevention strategies remains a challenge. This study examined the relationship between American Heart Association stroke prevention strategies, medication adherence, and recurrent stroke and the differences in implementing stroke prevention strategies based on clinic type, age, sex, gender, and insurance type. The study found no direct association between the implementation of stroke prevention strategies, medication adherence, and recurrent stroke. Findings showed that specialized stroke prevention clinics (SSC) were more effective in implementing strategies, particularly in dietary education, physical activity counseling, and sleep apnea screening, compared to the Neurology clinics, highlighting the value of specialized care in promoting comprehensive stroke prevention. Furthermore, lack of insurance was associated with lower implementation of prevention strategies, aligning with broader concerns regarding healthcare access for uninsured populations. Limitations include a small number of participants with recurrent stroke and other unmeasured confounders. Findings emphasize the need for dedicated stroke prevention clinics, improved patient education, greater adherence to guideline-based care, and the establishment of universal health insurance to improve access to care and reduce health disparities. Future research should explore interventions to improve long-term stroke prevention, particularly among high-risk populations.","abstract_has_math":false,"creators":["Okpala, Munachi N."],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Keele, Rebecca","Adams, Carin","Fredland, Nina"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-05","date_published":"2025-05","updated_at":"2026-07-27T21:19:32Z","subjects":["Stroke","Stroke prevention","Stroke outcomes","Stroke survivors","Recurrent stroke","Medication adherence","Post stroke care","Racial/healthcare disparities"],"languages":["English"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/11274/17103","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Keele, Rebecca","Adams, Carin","Fredland, Nina"]},{"key":"dc:creator","label":"Author","values":["Okpala, Munachi N."]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2026-02-27T17:48:39Z"]},{"key":"dc:date.issued","label":"Date","values":["2025-05"]},{"key":"dc:type","label":"Dc Type","values":["Dissertation"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Stroke","Stroke prevention","Stroke outcomes","Stroke survivors","Recurrent stroke","Medication adherence","Post stroke care","Racial/healthcare disparities"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["English"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://hdl.handle.net/11274/17103"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/11274/17103"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Stroke remains a leading cause of death and disability, imposing a significant burden on survivors and healthcare systems. Despite established guidelines by the American Heart Association/American Stroke Association, adherence to secondary stroke prevention strategies remains a challenge. This study examined the relationship between American Heart Association stroke prevention strategies, medication adherence, and recurrent stroke and the differences in implementing stroke prevention strategies based on clinic type, age, sex, gender, and insurance type. The study found no direct association between the implementation of stroke prevention strategies, medication adherence, and recurrent stroke. Findings showed that specialized stroke prevention clinics (SSC) were more effective in implementing strategies, particularly in dietary education, physical activity counseling, and sleep apnea screening, compared to the Neurology clinics, highlighting the value of specialized care in promoting comprehensive stroke prevention. Furthermore, lack of insurance was associated with lower implementation of prevention strategies, aligning with broader concerns regarding healthcare access for uninsured populations. Limitations include a small number of participants with recurrent stroke and other unmeasured confounders. Findings emphasize the need for dedicated stroke prevention clinics, improved patient education, greater adherence to guideline-based care, and the establishment of universal health insurance to improve access to care and reduce health disparities. Future research should explore interventions to improve long-term stroke prevention, particularly among high-risk populations."]},{"key":"dc:title","label":"Title","values":["Examining the relationship between American Heart Association stroke prevention strategies and the incidence of recurrent stroke in large urban stroke prevention and neurology clinics"]}]}],"canonical_facts":{"dc:contributor":["Keele, Rebecca","Adams, Carin","Fredland, Nina"],"dc:creator":["Okpala, Munachi N."],"dc:date.accessioned":["2026-02-27T17:48:39Z"],"dc:date.issued":["2025-05"],"dc:description.abstract":["Stroke remains a leading cause of death and disability, imposing a significant burden on survivors and healthcare systems. Despite established guidelines by the American Heart Association/American Stroke Association, adherence to secondary stroke prevention strategies remains a challenge. This study examined the relationship between American Heart Association stroke prevention strategies, medication adherence, and recurrent stroke and the differences in implementing stroke prevention strategies based on clinic type, age, sex, gender, and insurance type. The study found no direct association between the implementation of stroke prevention strategies, medication adherence, and recurrent stroke. Findings showed that specialized stroke prevention clinics (SSC) were more effective in implementing strategies, particularly in dietary education, physical activity counseling, and sleep apnea screening, compared to the Neurology clinics, highlighting the value of specialized care in promoting comprehensive stroke prevention. Furthermore, lack of insurance was associated with lower implementation of prevention strategies, aligning with broader concerns regarding healthcare access for uninsured populations. Limitations include a small number of participants with recurrent stroke and other unmeasured confounders. Findings emphasize the need for dedicated stroke prevention clinics, improved patient education, greater adherence to guideline-based care, and the establishment of universal health insurance to improve access to care and reduce health disparities. Future research should explore interventions to improve long-term stroke prevention, particularly among high-risk populations."],"dc:identifier":["https://hdl.handle.net/11274/17103"],"dc:identifier.uri":["https://hdl.handle.net/11274/17103"],"dc:language":["English"],"dc:subject":["Stroke","Stroke prevention","Stroke outcomes","Stroke survivors","Recurrent stroke","Medication adherence","Post stroke care","Racial/healthcare disparities"],"dc:title":["Examining the relationship between American Heart Association stroke prevention strategies and the incidence of recurrent stroke in large urban stroke prevention and neurology clinics"],"dc:type":["Dissertation"]},"updated_at":"2026-07-27T21:19:32Z"}