Novello Stacey, Bowen Mary Elizabeth, Griffioen Mari
School of Nursing, University of Delaware.
Dela J Public Health. 2019 Dec 18;5(5):52-55. doi: 10.32481/djph.2019.12.014. eCollection 2019 Dec.
Stroke is a leading cause of death and disability among adults age 65 and over in the United States. Modifiable risk factors for stroke include: obesity, poor nutrition, and lack of exercise. Sussex County, Delaware has the highest stroke rate among older adults in the state. Twenty-five percent of the population in Sussex County are 65 and over and about 70% of adults are overweight or obese. Consistent with the social ecological framework, the Stroke Population Risk Tool may be used at the individual level to identify those at an increased risk for stroke and to create individualized stroke specific education. At the community level, local nutrition, fitness, and senior services may be utilized - with older adults at the highest risk profile participating in a 12 week stroke education program focused on risk reduction behaviors, nutrition and exercise classes. At the policy level, the Walkability Assessment Tool may be utilized to encourage local municipalities to identify areas of the county which lack safe spaces to be physically active and to develop a plan to create a more exercise conducive environment. Taken together, the proposal discusses an implementable plan that may, in the long-term, effectively reduce the stroke rates of older adults in Sussex County and allow for the early identification of those at the greatest risk for stroke.
中风是美国65岁及以上成年人死亡和残疾的主要原因。中风的可改变风险因素包括：肥胖、营养不良和缺乏运动。特拉华州苏塞克斯县的老年人中风率在该州最高。苏塞克斯县25%的人口年龄在65岁及以上，约70%的成年人超重或肥胖。根据社会生态框架，中风人群风险工具可在个体层面用于识别中风风险增加的人群，并开展针对中风的个性化教育。在社区层面，可以利用当地的营养、健身和老年服务——让风险最高的老年人参加一个为期12周的中风教育项目，该项目侧重于降低风险行为、营养和运动课程。在政策层面，可利用步行适宜性评估工具鼓励当地市政当局确定该县缺乏安全运动空间的区域，并制定计划以营造一个更有利于运动的环境。总体而言，该提案讨论了一项可实施的计划，从长远来看，该计划可能有效降低苏塞克斯县老年人的中风率，并有助于早期识别中风风险最高的人群。
