Please select the eligibility criteria that correspond to the clinical trial below.
Title: RCT of an Intervention to Enable Stroke Survivors in Los Angeles County Hospitals to "Stay Within the Guidelines" (SUSTAIN)
Brief Summary: The purpose of this study is to test a newly developed outpatient care intervention called SUSTAIN (Systematic Use of Stroke Averting Interventions) for improving delivery of stroke preventive services at Los Angeles County hospitals and to measure the costs of running such an intervention.


Options:
A: Inclusion Criteria:

* Enrolled in a Durham VA Primary Care Clinic for at least one year
* Age ≥ 55 years old
* Diagnosis ICD 401.0, 401.1, or 401.9 on outpatient electronic encounter forms in the prior year
* Received a prescription for hypertensive medication (ACE inhibitors, beta blockers, calcium channel blockers, diuretics, alpha1 blockers, and/or central alpha2 agonists) in the previous year
* Inadequate BP control based on an average of prior 12-month clinic BP measurements
* Have a baseline EKG within the last 5 years to evaluate the presence of left ventricular hypertrophy.

Exclusion Criteria:

* Hospitalized at the DVAMC for a myocardial infarction (MI), coronary artery revascularization, or diagnosis of metastatic cancer in the past 6 months
* Prior history of stroke
* Active diagnosis of psychosis or dementia documented in medical record
* Participating in another chronic disease self-management study
* Resident of a nursing home
* Does not have access to a telephone
* Refusal to provide informed consent
B: Inclusion Criteria:

* Has experienced a stroke in the last 12 months
* 50 years of age or older
* Living in the community with phone access
* Mild to moderate stroke severity (i.e., modified Rankin Scale score ranging from 1 to 4)
* Able to communicate in English

Exclusion Criteria:

* Stroke of non-vascular origin
* Actively engaged in formal stroke rehabilitation services
* Uncontrolled arrhythmias
* Significant musculoskeletal or other neurological condition
* Severe aphasia or dysarthria
* Not medically stable
* Pain or co-morbidities which would preclude activity
* Living in long-term residential care
* Cognitive impairment, dependent in activities of daily living, and no caregiver participation
C: Inclusion Criteria:

* Patients of LAC+USC, Rancho Los Amigos, Olive View-UCLA, or Harbor-UCLA
* Patients who have had an acute transient ischemic attack (TIA) or ischemic stroke or carotid procedure within the last six months
* English or Spanish speaking
* At least 40 years of age
* Capable of giving informed consent (no proxies will be used to obtain consent)
* Blood pressure not optimally controlled (\>120/80, at least 72 hours post-stroke)

Exclusion Criteria:

* Age 39 years or younger
* Hemorrhagic stroke
* Patients with severe global disability which would preclude him/her from participating in group clinics
* Patients with advanced dementia
D: Inclusion Criteria:

* Black or Hispanic
* Age 18 years or older
* English or Spanish speaking
* Patients who have had an ischemic or hemorrhagic stroke
* Modified Rankin scale score of ≤ 3
* Average screening SBP ≥ 140 mm Hg from three BP readings taken at two separate visits with a validated automated device
* Receiving care at the study site for at least 6 months and planning to continue receiving care at the site for the next two years.

Exclusion Criteria:

* Being deemed unable to comply with the study protocol (either self-selected or by indicating during screening that he/she could not complete all requested tasks including using the HBPTM or interacting with the NCM if he/she were to be randomized to the intervention group)
* Participation in other clinical trials
* Diagnosis of cognitive dysfunction or significant psychiatric comorbidity (as indicated in medical record)
* Patients with upper arm circumference ≥ 52 cm, the maximum limit of the extra-large BP cuff
* Diagnosis of dialysis or end stage renal disease
* Relocating out of area or extended travel during study period
* Significant verbal speech impairment; unable to participate in intervention telephone sessions
* Pregnant women

Answer: C