Please select the eligibility criteria that correspond to the clinical trial below.
Title: Center for Stroke Disparities Solution (CSDS) Project II: Community Transitions Intervention (CTI)
Brief Summary: The Stroke CTI study is a 3 arm randomized, controlled trial designed to assess the effectiveness of a nurse practitioner (NP) only and a NP and health coach (HC) community transitions intervention (CTI) in reducing secondary stroke risk by helping patients lower their systolic blood pressure.


Options:
A: Inclusion Criteria:

* Newly admitted to the VNSNY post acute care program
* 21 years of age or older
* Black and/or Hispanic
* Speaks English or Spanish
* History of stroke or transient ischemic attack (TIA)
* Hypertension diagnosis
* Average screening systolic BP \>= 140 mmHg
* Is available to participate in intervention activities during the study timeframe if randomized to treatment group

Exclusion Criteria:

* Dialysis
* End stage renal disease
* Kidney transplant
* Severe heart failure
* Significant cognitive impairment. Unable to provide informed consent, accurate self-report, and/or unable to participate effectively in intervention
* Significant verbal speech impairment. Unable to participate in intervention telephone sessions
* Patients with upper arm circumference outside of valid use parameters for the automated device used for eligibility screening
B: Inclusion Criteria:

* Stroke or TIA in last 9 months
* Blood pressure above 140/85 when measured more than 1 week after stroke or on anti hypertensive medication

Exclusion Criteria:

* Severe illness likely to dominate pattern of care
* Already using home blood pressure monitor
* Non-English speaking
* Severe cognitive impairment (AMTS\<7)
* Known secondary hypertension
C: Inclusion Criteria:

* Acute cerebrovascular event (either TIA or minor Stroke within 14 days before study inclusion) according to the following definitions:
* TIA (clinical restitution within 24 hours and ABCD2-Score ≥3) or visible DWI-lesion in MRI
* Minor stroke (mRankin ≤2 at time of inclusion)
* Patients with at least one of the following treatable risk factors:
* Arterial Hypertension
* Diabetes mellitus
* Atrial Fibrillation
* Smoking
* Written informed consent prior to study inclusion
* Realistic perspective in keeping the outpatient appointments

Exclusion Criteria:

* Distance from home to study center not in suitable range for keeping the outpatient appointments
* cognitive impairment jeopardizing adherence to the support program
* Modified Rankin Score \>2 at time of study inclusion
* Malignant disease with life expectancy of less than 3 years
* relevant alcohol or other substance abuse (except for nicotine)
* Stroke or TIA etiology without options for evidence based secondary prevention (e.g. dissection or vasculitis)
D: INCLUSION:

Small subcortical ischemic stroke or subcortical TIA.

Inclusion criteria are based on TOAST criteria supplemented by required MRI data. All of the following criteria must be met:

* One of the lacunar stroke clinical syndromes (adapted from Fisher) lasting \> 24 hrs within the past 6 months
* Absence of signs or symptoms of cortical dysfunction such as aphasia, apraxia, agnosia, agraphia, homonymous visual field defect, etc.
* No ipsilateral cervical carotid stenosis (≥50%) by a reliable imaging modality done in an approved laboratory since the qualifying small subcortical stroke (S3), if hemispheric.
* No major-risk cardioembolic sources requiring anticoagulation or other specific therapy. Minor-risk cardioembolic sources will be permitted if anticoagulation is not prescribed by the patient's primary care physician.
* Subcortical TIA with corresponding lesion on DWI.
* MRI evidence of S3: a. Presence of an S3 (1.5 and 2 cm in diameter corresponding to the qualifying event on DWI; when TIA, ADC image must confirm lesion or T2/FLAIR (hyperintense lesions) (required for all brainstem events) OR multiple S3s on FLAIR/TI(\<1.5 cm in diameter) (hypointense lesions) b. Absence of cortical stroke and large subcortical stroke (recent or remote).

EXCLUSION:

To be eligible for entry into the study, the patient must not meet any of the criteria listed below:

* Disabling stroke (Modified Rankin Scale less than or equal to 4)
* Previous intracranial hemorrhage (excluding traumatic) or hemorrhagic stroke
* Age under 30 years
* High risk of bleeding (e.g. recurrent GI or GU bleeding, active peptic ulcer disease, etc)
* Anticipated requirement for long-term use of anticoagulants (e.g. recurrent DVT) or other antiplatelets
* Prior cortical stroke (diagnosed either clinically or by neuroimaging), or prior cortical or retinal TIA
* Prior ipsilateral carotid endarterectomy
* Impaired renal function: GFR \<40
* Intolerance or contraindications to aspirin or clopidogrel (including thrombocytopenia, prolonged INR)
* A score \< 24 (adjusted for age and education) on the Folstein Mini Mental Status Examination
* Medical contraindication to MRI
* Pregnancy or women of child-bearing potential who are not following an effective method of contraception
* Geographic or social factors making study participation impractical
* Unable or unwilling to provide informed consent
* Unlikely to be compliant with therapy/unwilling to return for frequent clinic visits
* Patients concurrently participating in another study with an investigational drug or device
* Other likely specific cause of stroke (e.g. dissection, vasculitis, prothrombotic diathesis, drug abuse)

Answer: A