# Video-based Intervention to Reduce Treatment and OUtcome Disparities in Adults Living with Stroke or Transient Ischemic Attack (VIRTUAL)

> **NIH NIH R01** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2024 · $159,200

## Abstract

A. SUMMARY AND SPECIFIC AIMS OF FUNDED PARENT GRANT
Hypertension is the most important risk factor for ischemic and hemorrhagic stroke, and reduction in blood
pressure (BP) after stroke is associated with reduced risk of stroke recurrence. For the majority of stroke
survivors (SS), hypertension remains poorly controlled early after an incident stroke. In the United States, Black
and Hispanic SS are more likely to have poorly controlled risk factors after stroke compared to White SS, and
Black and Hispanic SS have higher rates of stroke recurrence compared to White SS. Prior efforts to reduce
racial disparities in BP control among SS have been uniformly unsuccessful. Multicomponent care models that
include multidisciplinary approaches show promise for improving risk factor control after stroke. Social
determinants of health (SDOH) help to explain racial disparities in BP control and stroke recurrence, therefore
multidisciplinary post-stroke care models that target SDOH may be key to decreasing disparities in BP control.
Limited access to post-stroke outpatient care contributes to challenges in developing system-level interventions
for post-stroke BP control. Telemedicine and telemonitoring may be ideal approaches for improving access to
care in SS. The COVID-19 pandemic has led to rapid expansion of telemedicine for post-acute care in stroke
survivors; however, its effectiveness is unproven. Based on preliminary data at our center, we propose a
randomized trial testing an integrated multidisciplinary telehealth intervention, the Video-based Intervention to
Reduce Treatment and Outcome Disparities in Adults Living with Stroke or Transient Ischemic Attack
(VIRTUAL), in SS recently discharged home after inpatient hospitalization for ischemic stroke, hemorrhagic
stroke, or transient ischemic attack. The intervention will include post-discharge telehealth visits by a
multidisciplinary team, social risk assessments to facilitate social risk-targeted and social risk-informed care, and
home BP telemonitoring and management. The care team includes neurology providers (physician and nurse
practitioner), a pharmacist, and a social worker. Standard care will include follow-up with a neurologist and
primary care provider and pharmacist-assisted BP adjustment.
Aim 1: We will enroll 534 stroke survivors in a randomized comparative effectiveness trial of a 6-month
multidisciplinary telehealth intervention to test the impact of the intervention on key clinical outcomes, relative to
standard care.
Aim 1a: To examine the impact of the intervention on the primary outcome of BP control (24-hour ambulatory
BP <125/75 mmHg) assessed with ambulatory BP monitoring (ABPM) 6 months after hospital discharge.
Aim 1b: To evaluate the impact of the intervention on disparities in BP control at 6 months by examining
heterogeneity of effects on the primary clinical outcome (BP control) according to SS race and ethnicity.
Aim 1c: To assess the sustainability of intervention effect ...

## Key facts

- **NIH application ID:** 10978067
- **Project number:** 3R01MD016465-04S1
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Anjail Z Sharrief
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $159,200
- **Award type:** 3
- **Project period:** 2021-09-18 → 2025-03-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10978067

## Citation

> US National Institutes of Health, RePORTER application 10978067, Video-based Intervention to Reduce Treatment and OUtcome Disparities in Adults Living with Stroke or Transient Ischemic Attack (VIRTUAL) (3R01MD016465-04S1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10978067. Licensed CC0.

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