Stroke Experiences and Unmet Needs of Individuals of African Descent Living in High-Income Economy Countries: a Qualitative Meta-Synthesis.
African
Culturally tailored
Meta-synthesis
Perspectives
Qualitative
Stroke
Journal
Journal of racial and ethnic health disparities
ISSN: 2196-8837
Titre abrégé: J Racial Ethn Health Disparities
Pays: Switzerland
ID NLM: 101628476
Informations de publication
Date de publication:
31 Jul 2023
31 Jul 2023
Historique:
received:
02
06
2023
accepted:
14
07
2023
revised:
07
07
2023
medline:
31
7
2023
pubmed:
31
7
2023
entrez:
31
7
2023
Statut:
aheadofprint
Résumé
Stroke service disparities experienced by individuals of African descent highlight the need to optimize services. While qualitative studies have explored participants' unique experiences and service needs, a comprehensive synthesis is lacking. To address current knowledge gaps, this review aimed to synthesize existing literature on the experiences of individuals of African descent impacted by a stroke living in high-income economy countries in terms of stroke prevention, management, and care. A qualitative meta-synthesis incorporating a meta-study approach was conducted to obtain comprehensive and interpretive insights on the study topic. Four databases were searched to identify qualitative English-language studies published in the year 2022 or earlier on the experiences of adults of African descent who were at risk or impacted by a stroke and living in high-income economy countries. Study methods, theory, and data were analyzed using descriptive and interpretive analyses. Thirty-seven studies met our inclusion criteria, including 29 journal articles and 8 dissertations. Multiple authors reported recruitment as a key challenge in study conduct. Multiple existing theories and frameworks of health behaviours, beliefs, self-efficacy, race, and family structure informed research positionality, questions, and analysis across studies. Participant experiences were categorized as (1) engagement in stroke prevention activities and responses to stroke symptoms, (2) self-management and self-identity after stroke, and (3) stroke care experiences. This study synthesizes the experiences and needs of individuals of African descent impacted by stroke. Findings can help tailor stroke interventions across the stroke care continuum, as they suggest the need for intersectional and culturally humble care approaches.
Sections du résumé
BACKGROUND
BACKGROUND
Stroke service disparities experienced by individuals of African descent highlight the need to optimize services. While qualitative studies have explored participants' unique experiences and service needs, a comprehensive synthesis is lacking. To address current knowledge gaps, this review aimed to synthesize existing literature on the experiences of individuals of African descent impacted by a stroke living in high-income economy countries in terms of stroke prevention, management, and care.
METHODS
METHODS
A qualitative meta-synthesis incorporating a meta-study approach was conducted to obtain comprehensive and interpretive insights on the study topic. Four databases were searched to identify qualitative English-language studies published in the year 2022 or earlier on the experiences of adults of African descent who were at risk or impacted by a stroke and living in high-income economy countries. Study methods, theory, and data were analyzed using descriptive and interpretive analyses.
RESULTS
RESULTS
Thirty-seven studies met our inclusion criteria, including 29 journal articles and 8 dissertations. Multiple authors reported recruitment as a key challenge in study conduct. Multiple existing theories and frameworks of health behaviours, beliefs, self-efficacy, race, and family structure informed research positionality, questions, and analysis across studies. Participant experiences were categorized as (1) engagement in stroke prevention activities and responses to stroke symptoms, (2) self-management and self-identity after stroke, and (3) stroke care experiences.
CONCLUSIONS
CONCLUSIONS
This study synthesizes the experiences and needs of individuals of African descent impacted by stroke. Findings can help tailor stroke interventions across the stroke care continuum, as they suggest the need for intersectional and culturally humble care approaches.
Identifiants
pubmed: 37523144
doi: 10.1007/s40615-023-01725-z
pii: 10.1007/s40615-023-01725-z
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Heart and Stroke Foundation of Canada
ID : G-22-0033014
Organisme : Heart and Stroke Foundation of Canada
ID : G-22-0033014
Informations de copyright
© 2023. The Author(s).
Références
Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurol. 2007;6(2):182–7.
doi: 10.1016/S1474-4422(07)70031-5
Li L, et al. Trends in stroke incidence in high-income countries in the 21st century. Stroke. 2020;51(5):1372–80.
pmcid: 7185053
doi: 10.1161/STROKEAHA.119.028484
Krueger H, et al. Prevalence of individuals experiencing the effects of stroke in Canada. Stroke. 2015;46(8):2226–31.
doi: 10.1161/STROKEAHA.115.009616
Government of Canada. Stroke in Canada: highlights from the Canadian Chronic Disease Surveillance System. 2019 [cited 2022 September 23]; Available from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/stroke-canada-fact-sheet.html . Accessed 25 May 2023
Kalavina R, et al. The challenges and experiences of stroke patients and their spouses in Blantyre. Malawi Malawi Med J. 2019;31(2):112–7.
doi: 10.4314/mmj.v31i2.2
Ferro JM, Caeiro L, Figueira ML. Neuropsychiatric sequelae of stroke. Nat Rev Neurol. 2016;12(5):269–80.
doi: 10.1038/nrneurol.2016.46
Teoh V, Sims J, Milgrom J. Psychosocial predictors of quality of life in a sample of community-dwelling stroke survivors: a longitudinal study. Top Stroke Rehabil. 2009;16(2):157–66.
doi: 10.1310/tsr1602-157
World Bank. World Bank Country and Lending Groups. 2021 [cited 2021 September 21]; Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups . Accessed 25 May 2023
Towfighi A, Ovbiagele B. Health equity and actionable disparities in stroke: 2021 update. Stroke. 2022;53(3):636–42.
doi: 10.1161/STROKEAHA.122.035816
National Institute of Neurological Disorders and Stroke. Health disparities and health equity. 2022 [cited 2022 November 29]; Available from: https://www.ninds.nih.gov/about-ninds/strategic-plans-evaluations/strategic-plans/health-disparities-and-health-equity . Accessed 25 May 2023
Commission on Race and Ethnic Disparities. The report of the Commission on Race and Ethnic Disparities. 2021 [cited 2023 February 16, 2023]; Available from: https://www.gov.uk/government/publications/the-report-of-the-commission-on-race-and-ethnic-disparities/health . Accessed 25 May 2023
Leasure AC, et al. Stroke disparities among nonracial minorities in the all of us research program. Stroke. 2021;52(8):e488–90.
pmcid: 8316290
doi: 10.1161/STROKEAHA.121.034903
Gardener H, et al. Race and ethnic disparities in stroke incidence in the Northern Manhattan Study. Stroke. 2020;51(4):1064–9.
pmcid: 7093213
doi: 10.1161/STROKEAHA.119.028806
Jiménez MC, et al. Racial variation in stroke risk among women by stroke risk factors. Stroke. 2019;50(4):797–804.
pmcid: 6433502
doi: 10.1161/STROKEAHA.117.017759
Aradine EM, et al. Black-White differences in ischemic stroke risk factor burden in young adults. Stroke. 2022;53(3):e66–9.
doi: 10.1161/STROKEAHA.121.034314
Ellis C, et al. Racial/ethnic differences in poststroke rehabilitation outcomes. Stroke Res Treat. 2014;2014:950746.
pmcid: 4084586
Burke JF, et al. Racial differences in disability after stroke: results from a nationwide study. Neurology. 2014;83(5):390–7.
pmcid: 4132575
doi: 10.1212/WNL.0000000000000640
Ikeme S, et al. Evidence-based disparities in stroke care metrics and outcomes in the United States: a systematic review. Stroke. 2022;53(3):670–9.
doi: 10.1161/STROKEAHA.121.036263
Levine DA, et al. Interventions targeting racial/ethnic disparities in stroke prevention and treatment. Stroke. 2020;51(11):3425–32.
pmcid: 7594115
doi: 10.1161/STROKEAHA.120.030427
Renjith V, et al. Qualitative methods in health care research. Int J Prev Med. 2021;12:20.
pmcid: 8106287
Eaves YD. Caregiving in rural African American families for older adult stroke survivors. J Neurosci Nurs. 2006;38(4):270–330.
doi: 10.1097/01376517-200609000-00002
Eaves YD. ‘What happened to me’: rural African American elders’ experiences of stroke. J Neurosci Nurs. 2000;32(1):37–48.
doi: 10.1097/01376517-200002000-00009
Pierce LL, Wilkinson L. Caring and cultural maintenance and transformation for secondary urban family caregivers of persons with stroke. J Cult Divers. 1999;6(1):5–19.
Pierce LL. Caring and expressions of spirituality by urban caregivers of people with stroke in African American families. Qual Health Res. 2001;11(3):339–52.
doi: 10.1177/104973230101100305
Blixen C, et al. Stroke recovery and prevention barriers among young African-American men: potential avenues to reduce health disparities. Top Stroke Rehabil. 2014;21(5):432–42.
pmcid: 4720961
doi: 10.1310/tsr2105-432
Skolarus LE, et al. Individual and community determinants of calling 911 for stroke among African Americans in an urban community. Circ Cardiovasc Qual Outcomes. 2013;6(3):278–83.
pmcid: 3779662
doi: 10.1161/CIRCOUTCOMES.111.000017
Eaves, Y.D., Caregiving in rural African-American families for elderly stroke survivors. PhD dissertation. University of Michigan, 1998
Eaves YD. Rural African American caregivers’ and stroke survivors’ satisfaction with health care. Top Geriatr Rehabil. 2002;17(3):72–84.
doi: 10.1097/00013614-200203000-00007
Pierce LL. Caring and expressions of stability by urban family caregivers of persons with stroke within African American family systems. Rehabil Nurs : Off J Assoc Rehabil Nurs. 2001;26(3):100–16.
doi: 10.1002/j.2048-7940.2001.tb02213.x
Pierce V. Cultural humility in nursing building the bridge to best practices. Virginia Nurs Today. 2021;29(2):1–14.
Sajatovic M, et al. A targeted self-management approach for reducing stroke risk factors in African American men who have had a stroke or transient ischemic attack. Am J Health Promot. 2018;32(2):282–93.
doi: 10.1177/0890117117695218
Blixen C, et al. Using focus groups to inform the development of stroke recovery and prevention programs for younger African-American (AA) men. Top Stroke Rehabil. 2015;22(3):221–30.
pmcid: 4722950
doi: 10.1179/1074935714Z.0000000006
Moorley CR, Cahill S. Experiences of African-Caribbean women of their body after stroke. Nurs Times. 2018;114(5):52–5.
Moorley CR. Life after stroke: coping mechanism among African Caribbean women. Int J Stroke. 2015;10(SUPPL. 3):24.
Moorley CR, Cahill S, Corcoran NT. Life after stroke: coping mechanisms among African Caribbean women. Health Soc Care Community. 2016;24(6):769–78.
doi: 10.1111/hsc.12256
Erwin EJ, Brotherson MJ, Summers JA. Understanding qualitative metasynthesis: issues and opportunities in early childhood intervention research. J Early Interv. 2011;33(3):186–200.
doi: 10.1177/1053815111425493
Major CH, Savin-Baden M. An introduction to qualitative research synthesis. New York: Routledge; 2010.
Barnett-Page E, Thomas J. Methods for the synthesis of qualitative research: a critical review. BMC Med Res Methodol. 2009;9(1):59.
pmcid: 3224695
doi: 10.1186/1471-2288-9-59
Paterson BL, Thorne SE, Canam C, Jillings C. Meta-study of qualitative health research. Newbury Park, California: Sage Publications; 2001.
doi: 10.4135/9781412985017
Crotty, M.J. The foundations of social research: meaning and perspective in the research process. 1st ed. 1998, Newbury Park, California: Sage Publications Ltd.
Burr V, Social constructionism. London. UK: Routledge; 2015.
Singh H, et al. Applying ‘cultural humility’ to occupational therapy practice: a scoping review protocol. BMJ Open. 2022;12(7):e063655.
pmcid: 9345050
doi: 10.1136/bmjopen-2022-063655
Peters M, Marnie C, Tricco A, Pollock D, Munn Z, Alexander L, McInerney P, Godfrey C, Khalil H. Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Implementation. 2021;19(1):3–10.
doi: 10.1097/XEB.0000000000000277
Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
doi: 10.1080/1364557032000119616
Kokorelias KM, et al. Exploring the poststroke experiences and unmet needs of South Asian communities in high-income countries: a scoping review protocol. BMJ Open. 2022;12(4):e059017.
pmcid: 9047763
doi: 10.1136/bmjopen-2021-059017
Lee H, et al. A meta-study of qualitative research examining determinants of children’s independent active free play. Int J Behav Nutr Phys Act. 2015;12(1):5.
pmcid: 4318368
doi: 10.1186/s12966-015-0165-9
Fulton JIV, et al. Community-based culturally tailored education programmes for black adults with cardiovascular disease, diabetes, hypertension and stroke: a systematic review protocol of primary empirical studies. BMJ Open. 2022;12(6):e059883.
pmcid: 9189819
doi: 10.1136/bmjopen-2021-059883
Singh, H., Fulton, J., Mirzazada, S., Saragosa, M., Uleryk, E., Nelson, M. L. A., Community-based culturally tailored education programs for Black adults with chronic disease: a systematic review. J Racial Ethn Health Disparities, 2022. https://doi.org/10.1007/s40615-022-01474-5
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.
doi: 10.2307/2529310
Kokorelias, K.M., Cameron, J. I., Salbach, N. M., Colquhoun, H., Munce, S. E. P., Nelson, M. L. A., Martynuik, J., Steele Gray, C., Tang, T., Hitzig, S., Lindsay, P., Bayley, M. T., Wang, R. H., Kaur, N., Singh, H. Exploring the poststroke experiences and needs of South Asian communities living in high-income countries: findings from a scoping review. J Racial Ethn Health Disparities, 2023. https://doi.org/10.1007/s40615-023-01613-6
Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. Int J Evid Based Healthc. 2015;13(3):179–87.
doi: 10.1097/XEB.0000000000000062
Reynolds J, et al. Quality assurance of qualitative research: a review of the discourse. Health Res Policy and Sys. 2011;9(1):43.
doi: 10.1186/1478-4505-9-43
Santiago-Delefosse M, et al. Complexity of the paradigms present in quality criteria of qualitative research grids. SAGE Open. 2015;5(4):2158244015621350.
doi: 10.1177/2158244015621350
Aagaard H, et al. Parents experiences of neonatal transfer. A meta-study of qualitative research 2000-2017. Nurs Inq. 2018;25(3):12231.
doi: 10.1111/nin.12231
Page MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
pmcid: 8005924
doi: 10.1136/bmj.n71
Beal CC. Stroke education needs of African American women. Public Health Nurs. 2015;32(1):24–33.
doi: 10.1111/phn.12158
Beal, C.C. Women’s early symptom experience of stroke: a narrative study. PhD dissertation. University of Texas at Austin, 2010
Beal CC, Stuifbergen A, Volker D. A narrative study of women’s early symptom experience of ischemic stroke. J Cardiovasc Nurs. 2012;27(3):240–52.
doi: 10.1097/JCN.0b013e31821bf83c
Moorley C, Cahill S, Corcoran N. Stroke among African-Caribbean women: lay beliefs of risks and causes. J Clin Nurs. 2016;25(3–4):403–11.
doi: 10.1111/jocn.13061
Pierce, L.L. The experience and meaning of caring for urban family caregivers of persons with stroke. PhD dissertation. Wayne State University, 1998
Pierce LL, Roth EJ. Medical grand rounds. Coherence in the urban family caregiver role with African American stroke survivors. Top Stroke Rehabil. 2001;8(3):64–72.
doi: 10.1310/V5A2-6RKD-GJ9U-AMWC
Greenwood N, Ellmers T, Holley J. The influence of ethnic group composition on focus group discussions. BMC Med Res Methodol. 2014;14(1):107–107.
pmcid: 4177596
doi: 10.1186/1471-2288-14-107
Greenwood N, et al. Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors. BMJ Open. 2016;6(1):e009498.
pmcid: 4735197
doi: 10.1136/bmjopen-2015-009498
Agi, L. Perceptions of stroke risks among West African Male immigrants in San Diego. PhD dissertation. Walden University, 2016
Eisenstein AR, et al. A community-partnered approach to inform a culturally relevant health promotion intervention for stroke. Health Educ Behav. 2018;45(5):697–705.
doi: 10.1177/1090198117752787
Johnson, M.A. A qualitative analysis of the lived experiences of African Americans diagnosed with primary stroke. PhD dissertation. Capella University, 2014
Greene, J.V. Exploring the role of culture and race in stroke rehabilitation disparities. MSc dissertation. University of Miami, 2013
Strudwick A, Morris R. A qualitative study exploring the experiences of African-Caribbean informal stroke carers in the UK. Clin Rehabil. 2010;24(2):159–67.
doi: 10.1177/0269215509343847
Greenwood N, et al. Assessing satisfaction with social care services among black and minority ethnic and white British carers of stroke survivors in England. Health Soc Care Community. 2017;25(5):1571–80.
doi: 10.1111/hsc.12298
Bakas T, et al. Needs, concerns, strategies, and advice of stroke caregivers the first 6 months after discharge. J Neurosci Nurs. 2002;34(5):242–51.
doi: 10.1097/01376517-200210000-00004
Balakrishnan R, et al. Life after stroke in an urban minority population: a photovoice project. Int J Environ Res Public Health. 2017;14(3):293.
pmcid: 5369129
doi: 10.3390/ijerph14030293
Burns SP, Lutz BJ, Magwood GS. ‘Timing it right’: needs of African American adults with stroke and their caregivers across the care continuum. Ethn Health. 2022;27(2):420–34.
doi: 10.1080/13557858.2019.1693512
Jones, S.S. Anticipated response of African Americans to stroke symptoms. Master of Arts dissertation. University of Iowa, 2016
Chang E, et al. Characterizing beliefs about stroke and walking for exercise among seniors from four racial/ethnic minority communities. J Cross Cult Gerontol. 2018;33(4):387–410.
pmcid: 7672710
doi: 10.1007/s10823-018-9356-6
Anderson, S.H. An investigation of stroke awareness among African American women in faith based organizations: a mixed methods intervention study. PhD dissertation. A. T. Still University, 2016.
Magwood GS, et al. Barriers and facilitators of stroke recovery: perspectives from African Americans with stroke, caregivers and healthcare professionals. J Stroke Cerebrovasc Dis. 2019;28(9):2506–16.
pmcid: 6825439
doi: 10.1016/j.jstrokecerebrovasdis.2019.06.012
Lee S, et al. Power of peer support to change health behavior to reduce risks for heart disease and stroke for African American men in a faith-based community. J Racial Ethn Health Disparities. 2018;5(5):1107–16.
doi: 10.1007/s40615-018-0460-7
Perzynski A, et al. Informing policy for reducing stroke health disparities from the experience of African-American male stroke survivors. J Racial Ethn Health Disparities. 2016;3(3):527–36.
doi: 10.1007/s40615-015-0171-2
Pound C, Greenwood N. The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups. Disabil Rehabil. 2016;38(20):1987–99.
doi: 10.3109/09638288.2015.1107783
Beal CC. Keeping the story together: a holistic approach to narrative analysis. J Res Nurs. 2013;18(8):692–704.
doi: 10.1177/1744987113481781
Skolarus LE, et al. Perception among african americans towards calling 911 for acute stroke. Ann Neurol. 2012;72(16):S133.
Boehme AK, et al. Racial and gender differences in stroke severity, outcomes, and treatment in patients with acute ischemic stroke. J Stroke Cerebrovasc Dis. 2014;23(4):e255–61.
pmcid: 3989836
doi: 10.1016/j.jstrokecerebrovasdis.2013.11.003
Springer MV, Labovitz DL, Hochheiser EC. Race-ethnic disparities in hospital arrival time after ischemic stroke. Ethn Dis. 2017;27(2):125–32.
pmcid: 5398171
doi: 10.18865/ed.27.2.125
Siegler JE, et al. Ethnic disparities trump other risk factors in determining delay to emergency department arrival in acute ischemic stroke. Ethn Dis. 2013;23(1):29–34.
Jahan R, et al. Association between time to treatment with endovascular reperfusion therapy and outcomes in patients with acute ischemic stroke treated in clinical practice. JAMA. 2019;322(3):252–63.
pmcid: 6635908
doi: 10.1001/jama.2019.8286
Heikkilä I, et al. Fast protocol for treating acute ischemic stroke by emergency physicians. Ann Emerg Med. 2019;73(2):105–12.
doi: 10.1016/j.annemergmed.2018.07.019
Lecouturier J, et al. Systematic review of mass media interventions designed to improve public recognition of stroke symptoms, emergency response and early treatment. BMC Public Health. 2010;10:784.
pmcid: 3022856
doi: 10.1186/1471-2458-10-784
Sharrief AZ, et al. Stroke knowledge in African Americans: a narrative review. Ethn Dis. 2016;26(2):255–62.
pmcid: 4836907
doi: 10.18865/ed.26.2.255
Borkan JM, Culhane-Pera KA, Goldman RE. Towards cultural humility in healthcare for culturally diverse Rhode Island. Med Health R I. 2008;91(12):361–4.
Wippold GM, et al. Implementing barbershop-based health-promotion interventions for Black men: a systematic scoping review. Health Psychol. 2023;42(7):435–47.
doi: 10.1037/hea0001294
Bryant KB, Blyler CA, Fullilove RE. It’s time for a haircut: a perspective on barbershop health interventions serving Black men. J Gen Intern Med. 2020;35(10):3057–9.
pmcid: 7572982
doi: 10.1007/s11606-020-05764-8
Israel BA, et al. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19(1):173–202.
doi: 10.1146/annurev.publhealth.19.1.173
Lancaster KJ, et al. Obesity interventions in African American faith-based organizations: a systematic review. Obes Rev. 2014;15(4):159–76.
doi: 10.1111/obr.12207
Schwamm LH, et al. Race/ethnicity, quality of care, and outcomes in ischemic stroke. Circulation. 2010;121(13):1492–501.
doi: 10.1161/CIRCULATIONAHA.109.881490
Hosman, F.L., Engels, S., den Ruijter, H. M., Exalto, L. G. Call to action for enhanced equity: racial/ethnic diversity and sex differences in stroke symptoms. Front Cardiovasc Med. 2022;9: 874239. https://doi.org/10.3389/fcvm.2022.874239
Crenshaw K. Mapping the margins: intersectionality, identity politics, and violence against women of color. Stanford Law Review. 1991;43(6):1241–99.
doi: 10.2307/1229039
Collins PH. Intersectionality’s definitional dilemmas. Ann Rev Sociol. 2015;41(1):1–20.
doi: 10.1146/annurev-soc-073014-112142
Teteh DK, et al. Genetic ancestry, skin color and social attainment: The four cities study. PLoS ONE. 2020;15(8):e0237041
Watkins JC, et al. Creating and elaborating the cultural third: a doers-doing with perspective on psychoanalytic supervision. Am J Psychoanal. 2019;79:352–74.
doi: 10.1057/s11231-019-09203-4
Courtenay W. Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Soc Sci Med. 1982;2000(50):1385–401.
Mahalik J, Levi-Minzi M, Walker G. Masculinity and health behaviors in Australian men. Psychol Men Masculinity. 2007;8:240–9.
doi: 10.1037/1524-9220.8.4.240
Hammond WP, et al. Determinants of usual source of care disparities among African American and Caribbean Black men: findings from the National Survey of American Life. J Health Care Poor Underserved. 2011;22(1):157–75.
pmcid: 3062470
doi: 10.1353/hpu.2011.0016
Gilbert KL, et al. Visible and invisible trends in Black men’s health: pitfalls and promises for addressing racial, ethnic, and gender inequities in health. Annu Rev Public Health. 2016;37:295–311.
pmcid: 6531286
doi: 10.1146/annurev-publhealth-032315-021556
Trimble B, Morgenstern LB. Stroke in minorities. Neurol Clin. 2008;26(4):1177–90.
pmcid: 2621018
doi: 10.1016/j.ncl.2008.05.010
Gopaul U, et al. Age-specific information resources to address the needs of young people with stroke: a scoping review protocol. Syst Rev. 2022;11(1):275.
pmcid: 9761956
doi: 10.1186/s13643-022-02147-4
Akunyili G, Jones F. A preliminary exploration of self-management strategies amongst african and african-caribbean stroke survivors living in a london community. Int J Stroke. 2013;8(3):19–20.
Buchanan NT, Rios D, Case KA. Intersectional cultural humility: aligning critical inquiry with critical praxis in psychology. Women Ther. 2020;43(3–4):235–43.
doi: 10.1080/02703149.2020.1729469
Kelsall-Knight, L. Practising cultural humility to promote person and family-centred care. Nurs Stand. 2022;37:4. https://doi.org/10.7748/ns.2022.e11880
Zawawi NSM, et al. The unmet needs of stroke survivors and stroke caregivers: a systematic narrative review. J Stroke Cerebrovasc Dis. 2020;29(8):104875.
doi: 10.1016/j.jstrokecerebrovasdis.2020.104875
Camak DJ. Addressing the burden of stroke caregivers: a literature review. J Clin Nurs. 2015;24(17–18):2376–82.
doi: 10.1111/jocn.12884
Boden-Albala B, et al. Examining barriers and practices to recruitment and retention in stroke clinical trials. Stroke. 2015;46(8):2232–7.
pmcid: 5526461
doi: 10.1161/STROKEAHA.114.008564
Haley SJ, et al. Barriers and strategies for recruitment of racial and ethnic minorities: perspectives from neurological clinical research coordinators. J Racial Ethn Health Disparities. 2017;4(6):1225–36.
pmcid: 5547022
doi: 10.1007/s40615-016-0332-y
Calitri, R.,Carter, M., Code, C., Lamont, R., Dean, S., Tarrant, M. Challenges of recruiting patients into groupbased stroke rehabilitation research: reflections on clinician equipoise within the singing for people with aphasia (SPA) pilot trial. Front Psychol. 2021;12. https://doi.org/10.3389/fpsyg.2021.624952
Cunningham-Erves J, et al. Development and pilot implementation of guidelines for culturally tailored research recruitment materials for African Americans and Latinos. BMC Med Res Methodol. 2022;22(1):248.
pmcid: 9508728
doi: 10.1186/s12874-022-01724-4
Magwood GS, et al. High tech and high touch: recruitment strategies for enrolling African American stroke survivors in Community Based Intervention under Nurse Guidance after stroke (CINGS) trial. Contemp Clin Trials Commun. 2021;24:100844.
pmcid: 8441066
doi: 10.1016/j.conctc.2021.100844
Paterson, B., Thorne, S. E., Canam, C., Jillings, C. Meta-study of qualitative health research. SAGE Publications, Inc.: Thousand Oaks, California; 2001
Johnson JL, Adkins D, Chauvin S. A review of the quality indicators of rigor in qualitative research. Am J Pharm Educ. 2020;84(1):7120.
pmcid: 7055404
doi: 10.5688/ajpe7120
Shenton A. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf. 2004;22:63–75.