Please select the eligibility criteria that correspond to the clinical trial below.
Title: Implementing and Testing a Culturally-Tailored Stroke Risk Factor Reduction Intervention in Community Senior Centers
Brief Summary: Stroke is a cruel disease that disproportionately kills and disables African-Americans, Latinos, Chinese-Americans and Korean-Americans; seniors with high blood pressure are at particularly high risk. There is a higher incidence of hemorrhagic stroke in African Americans, Latinos, and Chinese Americans relative to non-Latino whites. Asian-Americans have up to 1.4 higher relative risk of stroke death compared to U.S. non-Latino whites. A critical need therefore exists for a sustainable and scalable mechanism to disseminate culturally-tailored stroke knowledge/prevention education in community-based settings where large numbers of these high-risk ethnic minority older adult groups are regularly served, such as in federally funded Multipurpose Senior Centers (MPCs) that exist across the nation (16 of which are in Los Angeles alone).

The overall objective of the proposed study is to develop and test the implementation of a training program for case managers at senior centers to implement a stoke knowledge/prevention education program among four high-risk ethnic minority older adult groups--Korean-American, Chinese-American, African-American, Latinos. We propose to develop a culturally-tailored case manager training curriculum, implement the training at 4 community-based sites, and evaluate the training model using a randomized wait-list controlled trial (n=244) testing the hypothesis that training case managers will decrease older adult participants' stroke risk in a sustainable fashion through increasing their preventative behavior (i.e. increasing their physical activity--mean steps/day--at 1 and 3 months).

Findings will inform similar community-academic partnership efforts around stroke and other disease-specific prevention research/interventions; they will also determine next steps in terms of whether this case manager-centric model can be scaled up and deployed in other community-based settings.


Options:
A: Inclusion Criteria:

1. Age 18 to 29 years
2. Identifies as male
3. Identifies as gay/bisexual or reports having sex with men in past 12 months
4. Identifies as Latino/Hispanic
5. Self-reports being HIV-uninfected
6. Resides in San Diego County, California
7. Speaks English or Spanish
8. Willing and able to provide informed consent
9. Willing to receive PrEP-related health care at FHCSD
10. Reports at least one HIV risk factor as informed by CDC guidelines

10a. MSM are at elevated risk for HIV (as per CDC) if they report one of the following:

* an HIV-infected sexual partner
* diagnosis of a bacterial STI within the past 12 months
* engaging in condomless anal sex with a non-monogamous partner in the past 12 months
* engaging in commercial sex work in the past 12 months
* injection of illicit drugs and sharing of injection equipment in the past 12 months
* engaging in drug treatment for injection drug use in the past 12 months.

Exclusion criteria:

1. HIV-infected
B: Inclusion Criteria:

* be a minimum of 18 years of age
* be of Latino descent
* report limited English language proficiency
* meet current MDD criteria
* have completed the 4th grade or higher either in their country of origin or in the US
* not have current substance abuse or dependence
* have no Bipolar or Psychotic Disorders
* not be currently receiving psychotherapy
* if currently taking antidepressants, demonstrate pharmacological stability as indicated by 3 or more consecutive months of use.
C: Inclusion Criteria:

* age 60 years and older
* reported history of high blood pressure

Exclusion Criteria:

* younger than 60 years of age
* not self-identifying as the racial-ethnic group for the intervention planned at that site
* inability to communicate verbally in the appropriate language in a group setting (either due to lack of language skills, hearing impairment, or other disability)
* inability to sit in a chair and participate in a 1-hour discussion session
* inability to walk (the use of assistive devices such as canes and walkers is not an exclusion criterion)
* not available to attend the baseline data collection session and subsequent weekly intervention sessions
* plans to move away from the region during the next 6 months
* lacking cognitive capacity to provide informed consent to participate
D: Inclusion Criteria:

* Hispanic immigrants living in or around Flint.
* Native speakers of Spanish, with varying degrees of English fluency and literacy.
* 18 years old and older.

Exclusion Criteria:

* Immigrants from other linguistic backgrounds will be excluded at this time because all program materials will be bilingually available in English and Spanish.
* Children will be excluded at this time because we are focusing on ESL health literacy for adults.

Answer: C