Abstract 3594: A Pilot Feasibility Study of Community Engaged Stroke Preparedness: The ASPIRE Project
Bibliographic record
Abstract
BACKGROUND: Lack of culturally appropriate education about stroke may prevent people from recognizing symptoms and/or seeking immediate care. The Stroke Warning Information and Faster Treatment (SWIFT) intervention reports increasing the proportion of prevalent stroke/TIA cases arriving under 4.5 hours using culturally tailored strategies, but few interventions have rigorously evaluated preparedness strategies in community settings. ASPIRE is a multi-dimensional program with a three-pronged approach (community, hospital, EMS) to acute stroke preparedness targeted to increased IV tPA utilization in underserved black communities in the DC metro area. METHODS: Using community engaged methodology, a skill-based approach to teaching community members to recognize acute stroke, call 911 and navigate the ER setting was developed. In the pilot phase, 50 education sessions were conducted in church, civic, educational and work organizations over a six month period in Ward 7 of the DC Metro area. Local ER and EMS staff were also in-serviced. We prospectively identified all hospital stroke admissions and EMS utilization information including acute stroke parameters for the 6 month pre and post intervention periods. Pre-post pilot intervention acute ischemic stroke parameters were compared. RESULTS: In the pre-intervention period, we identified 142 ischemic strokes in Ward 7: mean age 63 yrs; 63% male; 96% blacks. Fifty-six percent arrived via EMS, with a mean and median time to arrival of 1600 minutes (27.0 hours), and 890 minutes (14.8 hours), respectively. Following the intervention we identified 115 ischemic stroke cases: 66 yrs; 47% male; 89% black. Fifty percent arrived via EMS, mean and median time to arrival was 1423 min (23.7 hours) and 815 min (13.6 hours). In addition to this modest decrease in overall arrival times, an increased proportion of cases arriving in the 4.5 hours group was noted [pre 25% vs. post 28%, p=NS]. We were also able to match 104 ischemic stroke cases to EMS utilization sheets demonstrating feasibility for larger evaluation. CONCULSION: The ASPIRE pilot demonstrates feasibility of the multilevel community education intervention as well as feasibility of linking EMS and hospital records on a city wide scale. Despite the small number of ischemic strokes in this pilot phase, a modest reduction in hospital arrival times occurred in the post intervention phase. A city-wide intervention aimed at increasing the proportion of stroke patients treated with IV tPA is currently underway.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".