Under a five-year, $2.5 million grant from the National Institute on Minority Health and Health Disparities, a team of University of Michigan researchers and community partners is embarking on a novel project to increase acute stroke treatment rates in the community of Flint, Michigan.
Led by Lesli Skolarus, M.D., M.S., an associate professor of neurology at the U-M Medical School and a board-certified vascular neurologist, the team is testing a hospital- and community-based intervention called the “Stroke Ready” program that will attempt to address delays that can occur before and after arrival to the hospital, ultimately reducing the likelihood of stroke treatment and lessening its effectiveness.
More than 7 million stroke survivors in the U.S. are left with persistent disability after a stroke, such as weakness or speech and language problems, often because treatment was given too late, or not at all. “Time lost is brain lost,” as one saying goes. Each minute of delay results in an estimated loss of 1.9 million neurons, which, over the course of an hour without treatment, can be roughly compared to 3.6 years of normal brain aging.
Following the onset of a stroke, restoring blood flow to the brain as quickly as possible is critical for preventing disability and improving the chances of recovery. This crucial window for treatment is a narrow one – about 4 ½ hours – and the earlier the treatment, the better the outcome.
Stroke treatments must be administered in the emergency department, often in the form of a “clot-busting” drug called tPA, and can reduce the risk of disability by more than 30 percent. Yet because of a variety of barriers to timely evaluation and treatment, fewer than 5 percent of those who experience a stroke ever receive these therapies.
Because one of the most significant opportunities to increase stroke treatment rates lies in those critical first few moments immediately following a suspected stroke, a primary goal of the program aims to boost community “stroke preparedness” by helping people recognize the symptoms of stroke and encouraging them to call 9-1-1 immediately to get help on its way.
“Acute stroke treatments dramatically reduce post-stroke disability, but they are also extremely underutilized,” Skolarus explains. “We hope this program will boost stroke awareness in Flint and help get treatment to more stroke patients, so that the burden of stroke can be reduced in this community.”
The project is co-led by community partners that include Hurley Medical Center, Bridges into the Future, an African-American faith-based community group in Flint, and Community-Based Organization Partners, also headquartered in Flint, all of which Skolarus has collaborated with for many years. These partnerships were originally formed through the Partners In Research: Engagement for Action project. The Healthy Flint Research Coordinating Center, a collaboration between the Flint Community, UM-Flint, UM-Ann Arbor, and Michigan State University, is another partner in the project.