Effects of a Theory Based Stroke Prevention Program: A Pilot Study

Abstract

Background. Stroke is the fourth leading cause of death, and nonfatal stroke is a leading cause of long-term functional disability in the United States. Stroke can be prevented by managing risk factors and improving stroke knowledge. Although many health education programs have been shown to be effective for stroke prevention, those programs may not reach minority populations with a language barrier, such as older Korean Americans (KAs). The purposes of this study were to develop an 8-week theory-based stroke prevention (TBSP) program for older KAs and test its preliminary impact on stroke knowledge, healthy eating, and physical activity behaviors among KAs. Methods. A two-group, pretest-posttest, randomized controlled trial was employed. Using a convenience sampling method, participants were recruited from two senior centers (n = 73, age ≥ 55). Data were collected at baseline and at 8 weeks. The TBSP program included face-to-face lectures and discussion sessions. Descriptive statistics were performed on the sample and variables. A general linear model and logistic regression analysis were used to test the main hypotheses. Results. The majority of participants (n = 54, 74.0%) were female (mean age, 71.49 ± 6.25 years), and 65.8% were married. Thirty-two participants (43.8%) completed greater than high school. More than half of participants (n = 40, 55.0%) were engaged in low levels of physical activity (< 600 MET-minutes/wk). Total fat intake was adequate (50.25 ± 22.10 g/day), and sodium intake was high (3861.80 ± 1891.19 mg/day). The intervention group showed greater improvement in stroke knowledge (F = 6.88, p = .011) and physical activity (OR = 11.79, 95% CI = 1.94 - 71.65) and a reduction in total fat intake (F = 8.93, p = .004). There were no significant differences between the two groups for sodium and cholesterol intake or self-efficacy and outcome expectations for physical activity and healthy eating. Conclusion. The findings demonstrated some improvement in stroke knowledge and healthy behaviors after the TBSP program. High sodium intake in this population needs further intervention. More studies are needed with larger, more diverse older KA samples to improve generalizability.