Community-Based Hypertension Screening to Prevent Stroke in Underserved Urban Neighborhoods in French Guiana: A quasi-experimental study (Preprint)
Bibliographic record
Abstract
BACKGROUND: Hypertension is a leading contributor to stroke and cardiovascular disease in underserved populations. OBJECTIVE: This study aims to evaluate a community-based hypertension screening intervention in French Guiana's precarious urban neighborhoods. This trial will assess whether a structured, community health mediator-led intervention reduces stroke incidence among adults residing in socioeconomically precarious areas of the Communauté d'Agglomération du Centre Littoral (CACL). METHODS: This is a 27-month, monocentric, quasi-experimental study conducted in the CACL, targeting neighborhoods classified as precarious. Adults aged ≥18 years will be included unless they are legally protected or decline participation. Trained mediators will deliver blood pressure screening and health education through mobile units and home visits over a 24-month period. Participants with elevated readings will receive referrals and structured follow-up. The primary outcome is the change in stroke incidence before and after the intervention, using Programme de Médicalisation des Systèmes d'Information (PMSI) hospitalization data. Secondary outcomes include changes in the rates of other cardiovascular and renal events and antihypertensive treatment adherence. Comparisons will use interrupted time series analysis, chi-square tests, and regression models. Missing data will be evaluated, and multiple imputation will be applied as needed. RESULTS: This study was funded in 2022. Patient enrollment began in September 2023. As of September 4, 2025 (the end of field interventions), 23,289 participants had benefited from the intervention, including 10,901 (46.8%) who were formally enrolled and had completed questionnaires. Follow-up telephone calls were completed until December 2025. Data analysis is expected to be completed in the first quarter of 2026, with primary results anticipated to be published in 2026. CONCLUSIONS: This study will determine whether a scalable, community-mediated hypertension screening intervention reduces stroke incidence in underserved populations. TRIAL REGISTRATION: ClinicalTrials.gov NCT05814068; https://clinicaltrials.gov/study/NCT05814068. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/89318.
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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 | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".