{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:10:15Z","timestamp":1784113815779,"version":"3.55.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Poststroke follow\u2010up is associated with decreased rehospitalization and improved long\u2010term outcomes. However, rates are variable and dependent on numerous factors, some of which are fixed (age, sex) while others are potentially modifiable (medical knowledge, access to care). The National Institutes of Health has identified key factors for healthcare inequity using a framework based on Social Determinants of Health. It is currently unknown which of these factors are the largest drivers of poststroke follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We evaluated a prospectively collected cohort of \u22482600 patients treated for ischemic stroke between 2014 and 2022. Potential variables were identified using the Social Determinants of Health framework and categorized as nonmodifiable or modifiable.\n                      <jats:italic toggle=\"no\">T<\/jats:italic>\n                      tests,\n                      <jats:italic toggle=\"no\">\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      , and regression analyses were used to investigate their association with the likelihood of follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Fifty\u2010six percent of patients returned to the clinic. Greater degrees of impairment (due to stroke severity, advanced age, and premorbid condition), less education, scheduling inflexibility (due to occupation and employment status), and lack of home support were nonmodifiable factors associated with decreased follow\u2010up rates. Greater postdischarge needs (evaluated by rehabilitation status and discharge disposition) along with less family involvement during the discharge process were also associated with lower rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This study identifies key factors associated with poor follow\u2010up, defining an at\u2010risk population. Modifiable factors may serve as targets for enhanced postdischarge support, suggesting that patients may benefit from interventions aimed at family support and improved communication with rehabilitation facilities. The approach underscores the value of integrating Social Determinants of Health considerations into patient management to ensure equitable and effective healthcare delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.040986","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:02:10Z","timestamp":1745625730000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Social Determinants of Health Framework Identifies Patients at Risk for Loss to Follow\u2010Up After Stroke"],"prefix":"10.1161","volume":"14","author":[{"given":"Sarah","family":"Larson","sequence":"first","affiliation":[{"name":"The Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirlene","family":"John","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sriesakthi","family":"Gowrisankar","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Zhao","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Piner","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Dallasta","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2385-5074","authenticated-orcid":false,"given":"Elisabeth B.","family":"Marsh","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001052"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.46.suppl_1.tp341"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-023-03262-y"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.035816"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207566"},{"key":"e_1_3_1_7_2","unstructured":"City of Madison Affirmative Action Division . 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