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SDOH-Homecare Intervention Focus Team (SHIFT) Trial to Improve Stroke Outcomes

Not Applicable
Recruiting
Conditions
Stroke
Social Determinants of Health
Interventions
Behavioral: SHIFT team intervention
Registration Number
NCT06397937
Lead Sponsor
Columbia University
Brief Summary

Primary Goal:

To test the hypothesis that among stroke patients 18-75 years with ≥3 SDOH risk factors, SHIFT will improve: (1) functional outcomes as measured by the SIS (Primary Outcome), (2) physiological outcomes as measured by changes in blood pressure and cognition, (secondary outcomes) and (3) epigenetic allostatic load biomarkers (exploratory outcome) such as DNA methylation (DNAm) and telomere length, at 6 months and 1-year post-stroke, compared with usual care (UC).

Detailed Description

Adverse Social Determinants of Health (SDOH) have been shown increase stroke risk in a dose dependent manner. The SDOH-Homecare Intervention Focus Team (SHIFT) trial is a Phase 3, randomized, blinded outcome trial that tests the hypothesis that a homecare intervention shortly after discharge from an acute stroke unit by a team comprising a community health worker (CHW), a community social worker (CSW) and a community nurse (CN) can improve health outcomes among stroke patients with three or more SDOH compared with UC.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
250
Inclusion Criteria
  1. Ischemic stroke (arterial subtypes) or primary intracerebral hemorrhage (excluding diagnosis of probable CAA)
  2. Age 18-75 years old.
  3. Have at least 3 SDOH barriers from within the 5 SDOH domains (Social and Community, Education, Economic, neighborhood/environment, Health Care).
  4. Have a discharge plan to 1) home with or without home services, or 2) acute rehabilitation with plan to return home after.
  5. Pre-stroke Modified Rankin Scale score of ≤3
  6. Residence in New York City..
  7. English or Spanish speaking.
  8. Can provide informed consent and engage in the initial assessment prior to stroke discharge.
  9. Lives in a household with a telephone, and has a caregiver (family member or Home Health Aide) if not fully independent on discharge. If the patient requires a family member to assist with activities of daily living or decision-making, the family member must state a willingness to be present at home visits where their assistance is needed.
Exclusion Criteria
  1. Discharge disposition to a long term care facility.
  2. Diagnosis of dementia or other neurological neurological diagnosis that affects cognition.
  3. Diagnosis of active major depression.
  4. Aphasia severe enough to preclude initial examination.
  5. Impaired level of consciousness at initial cognitive assessment.
  6. Subarachnoid hemorrhage.
  7. Diagnosis of probable cerebral amyloid angiopathy by Boston criteria.
  8. Life expectancy less than 1 year.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionSHIFT team interventionThe SHIFT intervention team, comprising a community health worker (CHW), community social worker (CSW), and community nurse (CN),will make a first home visit within 72 hours of hospital discharge, and make regular visits to address SDOH barriers identified for each patient, provide individualized counseling, and assist with medication management, risk factor control, and health literacy.
Primary Outcome Measures
NameTimeMethod
Stroke Impact Scale v3.0baseline, 6 months and 1 year

a validated measure of disability and health-related quality of life after stroke

Secondary Outcome Measures
NameTimeMethod
Blood pressurebaseline, 6 months and 1 year

change in blood pressure from baseline

Stroke Specific Quality of Life (SSQOL)6 months and 1 year

validated quality of life measure

cognitionbaseline, 6 months and 1 year

Montreal Cognitive Assessment battery (MoCA)

Trial Locations

Locations (1)

Columbia University Medical Center

🇺🇸

New York, New York, United States

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