2023 American Academy of Neurology Abstract Website

Maha Almohamad¹, Dania Mofleh¹, Daphene Altema-Johnson², Mariam Ahmad³, Joseph Fries⁴, Munachi Okpala⁴, Audrey Cohen⁴, Daphne Hernandez⁵, Anjail Sharrief⁴
¹Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, ²John Hopkins Center for a Livable Future, ³Smith College, ⁴Neurology, McGovern Medical School at The University of Texas Health Science Center at Houston, ⁵Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston

Objective:

To assess the feasibility of food insecurity (FI) screening and prevalence of other social determinants of health (SDOH) associated with FI among stroke survivors attending outpatient clinic visits in the Stroke Transitions Education and Prevention clinical program.

Background:

FI, defined as limited or uncertain access to adequate food due to economic hardship and social condition, is a SDOH resulting in barriers to a healthy diet. Stroke survivors at risk for FI are at higher risk for a recurrent stroke event. FI screening may help identify patients needing access to food resources as a preventive measure to reduce stroke reoccurrence.

Design/Methods:

Cross-sectional design. Patients presenting for their initial telemedicine, or in-person clinic visit were screened using the 2-item Hunger Vital Scale through electronic and paper-based self-report surveys between February 1-July 31, 2021. Multivariable logistic regression examined associations between SDOH and FI.

Results:

Among 476 stroke patients within the stroke clinic, 415 (87.2%) surveys were completed; 258 (62.2%) electronically and 157 (37.8%) paper-based. Overall, 13.9% of the patients experienced FI, and a higher prevalence of FI was observed among those who completed paper-based compared to electronic surveys (21.4% vs 9.9%, P=0.002). More Black patients (36.5%) reported FI compared to White (21.1%) and Hispanic (30.8%) patients (P<0.05). Those who reported disability or unemployment had higher rates of FI compared to employed and retired patients (P=0.000). Black patients had higher odds of reporting FI compared to White patients (AOR=3.02, 95% CI: 1.04; 8.79).

Conclusions:

FI screening is feasible. FI is more prominent in the current sample of stroke survivors compared to the national average. SDOH prevalent characteristics, Black and unemployed patients, align with the literature on structural disparities affecting communities. The results provide information needed to create a social-risk informed index that can be used to target care in stroke survivors.