# Optimizing telehealth to improve secondary stroke prevention > **NIH NIH K23** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2024 · $229,635 ## Abstract PROJECT SUMMARY/ABSTRACT Stroke prevalence is predicted to reach 10 million by 2030, with the largest increase in Hispanic and Black populations. About half of patients who survive a stroke are at increased risk of stroke recurrence within three months, making this a critical period for preventative intervention. While hypertension is the most important modifiable risk factor for stroke, blood pressure (BP) remains poorly controlled among many largely due to low medication adherence and particularly among ethno-racial minorities. Additionally, physical activity (PA), which is linked to lower BP, is low among patients following a stroke. There is evidence that behavioral and medical interventions could reduce recurrent events by 80%, but such interventions are lacking, and real-world application is limited. The goal of this proposal is to develop and test a scalable, patient-centered, telehealth- delivered behavioral intervention that promotes self-regulation for multiple health behaviors, i.e., BP medication adherence and PA. I hypothesize that a theory-based behavioral intervention that increases allocated attention for enhanced self-regulation can improve multiple preventive health behaviors. Using translational research models and an optimization trial design, I will investigate the feasibility of an intervention that utilizes infographic-guided motivational interviewing (MI) and self-monitoring with behavioral and environmental feedback during the first three months following a stroke. In Aim 1, I will identify educational content in an MI intervention for BP control and PA in post-stroke patients and culturally adapt it with input from local diverse stroke patients and their professionally diverse providers. To support the adapted MI, infographics will be generated in English and Spanish with patient's own data for automated delivery. In Aim 2, I will conduct a MOST (Multiphase Optimization Strategy)-inspired pilot feasibility trial to identify feasible components for BP control, PA, or both. Finally, as an Exploratory Aim, I will conduct a preliminary assessment of intervention efficacy and target health behavior change mechanisms. A detailed understanding of how each component performs and impacts health behavior will lead to more targeted patient-centered interventions while addressing inequities for improved health outcomes. This work will also allow me to develop valuable expertise in behavioral interventions. I have a clinical background in neurology with an emphasis on stroke and cerebrovascular diseases and have a Master's degree in Patient Oriented Research. I am committed to a career in stroke prevention research and plan to use the training obtained through this NIH Career Development Award to support my future work in this field. With the long-term goal of independence as a physician-investigator with expertise in behavioral interventions for stroke prevention, I have assembled a multidisciplinary mentoring team and set short-t... ## Key facts - **NIH application ID:** 10949348 - **Project number:** 1K23NS138698-01 - **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES - **Principal Investigator:** Imama A Naqvi - **Activity code:** K23 (R01, R21, SBIR, etc.) - **Funding institute:** NIH - **Fiscal year:** 2024 - **Award amount:** $229,635 - **Award type:** 1 - **Project period:** 2024-07-01 → 2029-06-30 ## Primary source NIH RePORTER: https://reporter.nih.gov/project-details/10949348 ## Citation > US National Institutes of Health, RePORTER application 10949348, Optimizing telehealth to improve secondary stroke prevention (1K23NS138698-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10949348. Licensed CC0. --- *[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*