{"title":"Educational and Socioeconomic Correlates of Stroke Risk Behaviors: Findings from the SPRINT INDIA Trial.","authors":"Shweta Jain Verma, Gurnoor Kaur, Arya Devi, Deepti Arora, Aneesh Dhasan, P N Sylaja, Dheeraj Khurana, Vijaya Pamidimukkala, Biman Kanti Ray, Vivek Nambiar, Sanjith Aaron, Gaurav Mittal, Sundarachary Nagarjunakonda, Aparna R Pai, Sankar Prasad Gorthi, Somasundaram Kumaravelu, Yerasu Muralidhar Reddy, Sunil Narayan, Nomal Chandra Borah, Rupjyoti Das, Girish Baburao Kulkarni, Vikram Huded, Thomas Mathew, Mv Padma Srivastava, Rohit Bhatia, Pawan Kumar Ojha, Jayanta Roy, Sherly Mary Abraham, Anand Girish Vaishnav, Arvind Sharma, Sheikh Jabeen, Abhishek Pathak, Sanjeev Kumar Bhoi, Sudhir Sharma, Sulena Sulena, Aralikatte Onkarappa Saroja, Neetu Ramrakhiani, Madhusudhan Byadarahalli Kempegowda, Mahesh Kate, Tina George, Ivy Sebastian, Meenakshi Sharma, Rupinder Dhaliwal, Rahul Huilgol, Jeyaraj D Pandian","doi":"10.4103/aian.aian_933_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) trial was a randomized control trial that enrolled 4298 stroke patients and administered educational interventions at 31 centers across India, with the aim to reduce recurrent stroke through increased stroke knowledge. This SPRINT INDIA trial post hoc study aims to investigate the incidence of recurrent stroke, high-risk transient ischemic attack (TIA), acute coronary syndrome (ACS), death, and lifestyle behavioral factors at 1 year. In addition, it examines the relationship between patients' baseline characteristics and education levels, risk factors, and outcomes and performs subgroup analysis within the intervention and control groups.</p><p><strong>Methods: </strong>Participants were randomly assigned (1:1) to either intervention or control group through computer-based randomization on web. Intervention included stroke prevention Short Message Service messages, short-duration videos, and printed workbooks. Baseline assessments captured demographic and educational data, classifying patients into three categories: no schooling, less than high school, and high school or above. Primary outcome was a composite of recurrent stroke, high-risk TIA, ACS, and mortality at 1 year. Chi-square tests and analysis of variance were used to evaluate educational disparities across various variables.</p><p><strong>Results: </strong>The intervention did not reduce primary outcomes at 1 year among patients with different educational levels. Higher educational group was associated with enhanced medication adherence (94.3% vs 85.4%; P < 0.001), increased physical activity (5497.91 ± 4117.7 vs 6169.91±4828.8; P < 0.001), lower triglyceride levels, and decreased engagement in behavioral risk factors like alcohol intake (5.1% vs 6.8%; P = 0.013) and tobacco use (smoked and chewed) (4% vs 7.9%; P < 0.001 and 5.8% vs 11.6%; P = 0.020).</p><p><strong>Conclusions: </strong>Personalized secondary stroke prevention, tailored to educational levels, is crucial for effective stroke management.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Indian Academy of Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/aian.aian_933_24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) trial was a randomized control trial that enrolled 4298 stroke patients and administered educational interventions at 31 centers across India, with the aim to reduce recurrent stroke through increased stroke knowledge. This SPRINT INDIA trial post hoc study aims to investigate the incidence of recurrent stroke, high-risk transient ischemic attack (TIA), acute coronary syndrome (ACS), death, and lifestyle behavioral factors at 1 year. In addition, it examines the relationship between patients' baseline characteristics and education levels, risk factors, and outcomes and performs subgroup analysis within the intervention and control groups.
Methods: Participants were randomly assigned (1:1) to either intervention or control group through computer-based randomization on web. Intervention included stroke prevention Short Message Service messages, short-duration videos, and printed workbooks. Baseline assessments captured demographic and educational data, classifying patients into three categories: no schooling, less than high school, and high school or above. Primary outcome was a composite of recurrent stroke, high-risk TIA, ACS, and mortality at 1 year. Chi-square tests and analysis of variance were used to evaluate educational disparities across various variables.
Results: The intervention did not reduce primary outcomes at 1 year among patients with different educational levels. Higher educational group was associated with enhanced medication adherence (94.3% vs 85.4%; P < 0.001), increased physical activity (5497.91 ± 4117.7 vs 6169.91±4828.8; P < 0.001), lower triglyceride levels, and decreased engagement in behavioral risk factors like alcohol intake (5.1% vs 6.8%; P = 0.013) and tobacco use (smoked and chewed) (4% vs 7.9%; P < 0.001 and 5.8% vs 11.6%; P = 0.020).
Conclusions: Personalized secondary stroke prevention, tailored to educational levels, is crucial for effective stroke management.
背景和目的：印度结构化半互动式卒中预防方案二级预防（SPRINT India）试验是一项随机对照试验，招募了4298名卒中患者，并在印度31个中心进行了教育干预，目的是通过增加卒中知识来减少卒中复发。这项SPRINT印度试验旨在调查1年后复发性卒中、高风险短暂性脑缺血发作（TIA）、急性冠状动脉综合征（ACS）、死亡和生活方式行为因素的发生率。此外，它还检查了患者的基线特征与教育水平、危险因素和结果之间的关系，并在干预组和对照组中进行了亚组分析。方法：通过网络计算机随机化，将参与者按1:1的比例随机分为干预组和对照组。干预措施包括中风预防短信服务信息、短时间视频和打印的工作手册。基线评估收集了人口统计和教育数据，将患者分为三类：未受教育、高中以下和高中及以上。主要结局是复发性卒中、高风险TIA、ACS和1年死亡率的综合结果。使用卡方检验和方差分析来评估不同变量之间的教育差异。结果：干预没有降低不同教育水平患者1年的主要结局。高学历组与药物依从性增强相关(94.3% vs 85.4%；P < 0.001)，体力活动增加(5497.91±4117.7 vs 6169.91±4828.8；P < 0.001)，较低的甘油三酯水平，并减少参与行为风险因素，如饮酒(5.1% vs 6.8%；P = 0.013)和烟草使用（吸烟和咀嚼）(4% vs 7.9%；P < 0.001, 5.8% vs 11.6%；P = 0.020)。结论：针对教育水平的个性化卒中二级预防对有效的卒中管理至关重要。
期刊介绍：
The journal has a clinical foundation and has been utilized most by clinical neurologists for improving the practice of neurology. While the focus is on neurology in India, the journal publishes manuscripts of high value from all parts of the world. Journal publishes reviews of various types, original articles, short communications, interesting images and case reports. The journal respects the scientific submission of its authors and believes in following an expeditious double-blind peer review process and endeavors to complete the review process within scheduled time frame. A significant effort from the author and the journal perhaps enables to strike an equilibrium to meet the professional expectations of the peers in the world of scientific publication. AIAN believes in safeguarding the privacy rights of human subjects. In order to comply with it, the journal instructs all authors when uploading the manuscript to also add the ethical clearance (human/animals)/ informed consent of subject in the manuscript. This applies to the study/case report that involves animal/human subjects/human specimens e.g. extracted tooth part/soft tissue for biopsy/in vitro analysis.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
