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(Stroke. 2001;32:1360.)
© 2001 American Heart Association, Inc.

Original Contributions

Barriers to Acute Stroke Therapy and Stroke Prevention in Mexican Americans

Lewis B. Morgenstern, MD; Lyn Steffen-Batey, PhD; Melinda A. Smith, MPH Lemuel A. Moyé, MD, PhD

From the Stroke Program, Department of Neurology, University of Texas Medical School, Houston (L.B.M., M.A.S.), and the Epidemiology Research Center (L.B.M., L.S-B.) and Department of Biometry (L.A.M.), University of Texas School of Public Health, Houston.

Correspondence to Lewis B. Morgenstern, MD, Department of Neurology, University of Texas at Houston, 6431 Fannin, Room 7.044, Houston, TX 77030. E-mail Lewis.Morgenstern{at}uth.tmc.edu

Background and Purpose—The purpose of this study was to identify specific targets to improve acute stroke treatment and stroke prevention in the Mexican American (MA) community.

Methods—A professional, academic survey research team provided structured questions and elicited responses from 719 subjects identified by random-digit dialing in the biethnic community of Corpus Christi, Texas. This community of approximately 300 000 is approximately half MA and half non-Hispanic white (NHW). The cooperation rate for the survey was 58%.

Results—MAs (n=357) were younger, less well educated, and had lower family income than NHWs (n=362, P=0.001). MAs had a higher prevalence of diabetes mellitus (P=0.001) but similar rates of hypertension, elevated cholesterol, and current tobacco use. MAs less commonly recognized that acute stroke therapy existed (P=0.029), were less likely to acknowledge a time window for acute stroke treatment (P=0.001), and were more reticent to say they would call 911 for stroke symptoms (P=0.01) than NHWs. MAs were significantly less able to recall stroke symptoms and risk factors than NHWs. Only approximately 20% of both groups identified stroke as the No. 1 cause of disability. MAs expressed less confidence in their ability to prevent stroke (P<0.001), more distrust in the medical establishment (P=0.007), and more concern that money impedes their seeking medical care (P<0.001).

Conclusions—There are significant barriers to both acute stroke treatment and stroke prevention in MAs. This study identifies specific targets amenable for testing in an intervention project following confirmation by a methodology other than telephone survey.

Key Words: Hispanic Americans • Mexican Americans • minority groups • stroke, acute • stroke prevention

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