Preventing Recurrence of Thromboembolic Events Through Coordinated Treatment in the District of Columbia (PROTECT DC)

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Chelsea Kidwell, M.D., Georgetown University
ClinicalTrials.gov Identifier:
NCT00703274
First received: June 20, 2008
Last updated: February 20, 2013
Last verified: February 2013

June 20, 2008
February 20, 2013
April 2008
January 2013   (final data collection date for primary outcome measure)
  • Low Density Lipoprotein Value [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Systolic Blood Pressure Value [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Hemoglobin A1C Value [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Pill count of antiplatelet therapy medications [ Time Frame: 1 year ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT00703274 on ClinicalTrials.gov Archive Site
  • Smoking Cessation Status [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • AHA Diet Status [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Exercise Status [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Stroke Knowledge Level [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Systolic Blood Pressure Value [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Hemoglobin A1C Value [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Pill count of antiplatelet therapy medications [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Smoking Cessation Status [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • AHA Diet Status [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Exercise Status [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Stroke Knowledge Level [ Time Frame: 1 year ] [ Designated as safety issue: No ]
Not Provided
Not Provided
 
Preventing Recurrence of Thromboembolic Events Through Coordinated Treatment in the District of Columbia
Preventing Recurrence of Thromboembolic Events Through Coordinated Treatment in the District of Columbia

The purpose of this study is to refine and evaluate the Preventing Recurrence of Thromboembolic Events through Coordinated Treatment in the District of Columbia (PROTECT DC) intervention. PROTECT DC is a program consisting of in-hospital education coupled with community-based "stroke navigators" and is designed to reduce the rate of vascular events or death in a population of underserved individuals with stroke.

Despite significant advances in the prevention and treatment of cerebrovascular disease in the last few decades, stroke remains the third leading cause of death and the leading cause of adult disability in the United States. For the population that has experienced a cerebrovascular event, the risk of future stroke is greatly increased. The initiation of effective secondary prevention strategies is most effective when implemented early (before disabling stroke occurs), monitored frequently, and maintained long-term after a cerebrovascular event.

The Preventing Recurrence of Thromboembolic Events through Coordinated Treatment in the District of Columbia (PROTECT DC) intervention uses stroke navigators to help people who have suffered a stroke implement secondary prevention strategies. Stroke navigators are lay persons trained to provide education on secondary prevention behavior, and trained to navigate the health and human service system. The goals are to help individuals who have had a stroke obtain the necessary services and programs to engage in secondary prevention behaviors and, ultimately, to prevent the recurrence of stroke.

Interventional
Phase 2
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Supportive Care
Stroke
Behavioral: PROTECT DC
PROTECT DC facilitates the initiation of secondary prevention behaviors in an attempt to prevent the recurrence of stroke among participants. The program trains a lay person, called a stroke navigator, to provide participants with education on secondary prevention behavior and to navigate the health and human service system, which will assist participants in obtaining the necessary services and programs to engage in secondary prevention behaviors.
Other Names:
  • navigator model
  • navigation intervention
  • community health worker intervention
  • Experimental: Navigation Group
    Participants enrolled in this group will receive education concerning primary and secondary PROTECT DC goals. Primary PROTECT DC goals adhere to the following medication directives: 1) Anti-hypertensive, 2) Lipid Lowering, 3) Anti-Coagulant, and 4) Anti-Diabetic. PROTECT DC secondary goals include the following behaviors 1) Smoking Cessation, 2) Consuming an AHA Diet, 3) Regular Exercise, and 4) Knowledge of Stroke Risk and Warning Signs. Participants will also receive assistance with overcoming resource-related barriers to the PROTECT DC goals.
    Intervention: Behavioral: PROTECT DC
  • No Intervention: Control Group
    Participants enrolled in this group will receive periodic follow up through mailings, phone calls etc to ensure availability for 1 year assessment.
Dromerick AW, Gibbons MC, Edwards DF, Farr DE, Giannetti ML, Sánchez B, Shara NM, Fokar A, Jayam-Trouth A, Ovbiagele B, Kidwell CS. Preventing recurrence of thromboembolic events through coordinated treatment in the District of Columbia. Int J Stroke. 2011 Oct;6(5):454-60. doi: 10.1111/j.1747-4949.2011.00654.x.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
230
January 2013
January 2013   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Age ≥ 18 years
  • Hospitalized due to ischemic stroke* or intercurrent ischemic stroke* event within the past 30 days OR Transient ischemic attack, confirmed by stroke neurologist.
  • Atherogenic etiology(large vessel, small vessel, cryptogenic with at least one stroke risk factor, or embolic stroke due to atherogenic cardiac disease) as defined by TOAST criteria.
  • Community dwelling prior to stroke
  • Resides within the District of Columbia or closely nearby (preferably within 10 miles of the DC border)
  • Expected to reside within the District of Columbia or closely nearby (preferably within 10 miles of DC border)
  • Caregiver or interested party available, if moderately or severely disabled (not required to actually reside with participant)
  • Sufficient number of collateral contacts to assure follow-up. Defined as: Preferred: at least 6 contacts; and No fewer than 3 contacts (unless approved by study PI/co-PI/co-I)
  • Judged likely to return to community setting at completion of post-acute care.

Exclusion Criteria:

  • Non-atherogenic cause of stroke
  • NIHSS > 20
  • Any medical condition that would limit participation in follow up assessments
  • Baseline dementia per informant report (AD8) or screening assessment (Short Blessed Memory Orientation Concentration Test)
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00703274
U54NS057405, 1U54NS057405-01A1
No
Chelsea Kidwell, M.D., Georgetown University
Georgetown University
National Institute of Neurological Disorders and Stroke (NINDS)
Principal Investigator: Alexander Dromerick, MD National Rehabilitation Hospital, Georgetown University
Principal Investigator: Chelsea S. Kidwell, MD Washington Hospital Center, National Rehabilitation Hospital, Georgetown University
Georgetown University
February 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP