Social network intervention to improve blood pressure control after stroke: The TEAMS-BP randomized clinical trial

Abstract

Social connections play an important role in predicting health outcomes after a stroke. In the context of clinical medicine, a social network theory proposes that each patient is embedded in a personal social network of interpersonal connections that provide social support, information, and behavioral cues. However, the effectiveness of activating and harnessing supportive personal social networks remains uncertain, particularly within healthcare situations where individualism prevails. As an initial step towards developing interventions for healthier social networks in clinical practice, we conducted a randomized controlled trial in stroke survivors. This trial compared a network intervention versus individual counseling for 3 months with the aim of lowering blood pressure after stroke. Over 2 years, we recruited 45 stroke survivors, with 24 assigned to the network intervention and 21 to the individual counseling group. Results indicated no significant difference in the primary outcome of absolute systolic blood pressure difference over 3 months between the two groups. However, subgroup analyses revealed that patients within small and close-knit networks, known as high constraint networks, who received the network intervention had a significantly larger reduction in blood pressure than patients within large and open, low constraint, networks. The study's findings are preliminary due to dropout rates in both arms, and variable engagement of network members in the intervention arm. Nevertheless, our results suggest the potential of leveraging social networks to enhance health outcomes in specific subgroups of stroke survivors, highlighting avenues for further research and intervention development. Clinical Trial Unique Identifier: NCT05258890.