Barriers to acute stroke therapy and stroke prevention in Mexican Americans

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.