Phone-based Intervention Under Nurse Guidance After Stroke 2
Phone-based Intervention Under Nurse Guidance After Stroke 2
The overall objective of Phone-based Intervention under Nurse Guidance after Stroke II
 (PINGS-2) is to deploy a hybrid study design to firstly, demonstrate the efficacy of a
 theoretical-model-based, mHealth technology-centered, nurse-led, multi-level integrated
 approach to substantially improve longer term BP control among 500 recent stroke patients
 encountered at 10 hospitals in Ghana. Secondly, PINGS II seeks to develop an implementation
 strategy for routine integration and policy adoption of mhealth for post-stroke BP control in
 a LMIC setting. The investigators will leverage experience gained from the NIH Global Brain
 Disorders funded R21 pilot study (NS094033) to test efficacy of a refined,
 culturally-tailored, and potentially implementable intervention aimed at addressing the
 premier modifiable risk for stroke & other key variables in an under-resourced system
 burdened by suboptimal care & outcomes.
Inclusion Criteria:

 -  age ≥ 18 years (stroke is commoner above this age cut-off)

 -  male or females (sex is a biologic variable of interest)

 -  recent stroke (within one month of symptom onset)- stroke may be ischemic or
 hemorrhagic based on brain imaging or diagnosed clinically using the locally validated
 version of the 8-item questionnaire for verifying stroke free status (8-QVSFS) when
 neuroimaging is not feasible

 -  uncontrolled HTN (SBP ≥ 140 mmHg at both the last clinical encounter post-stroke and
 the eligibility screening visit) - SBP is used as the selection variable since most
 African hypertensives <60 years have systolic or combination systolic/ diastolic HTN
 and for most patients, controlling SBP also results in DBP control

 -  patients or family carers should own a basic mobile phone that can receive text/audio
 messages.

 Exclusion Criteria:

 - Any condition that would limit participation in follow up assessments, such as severe
 cognitive impairment/dementia (MMSE ≤24).