Barriers to risk factor control may differ by race/ethnicity. The goal of this study was to identify barriers to stroke awareness and risk factor management unique to Hispanics as compared to non-Hispanic whites (NHWs). We performed a prospective study of stroke patients from an academic Stroke Center in Arizona and surveyed members of the general community. Questionnaires included: the Duke Social Support Index (DSSI), the Multidimensional Health Locus of Control (MHLC) Scale, a stroke barriers questionnaire, and a Stroke Awareness Test. Of 145 stroke patients surveyed (72 Hispanic; 73 NHW), Hispanics scored lower on the Stroke Awareness Test compared to NHWs (72.5% vs. 79.1%, p = 0.029). Hispanic stroke patients also reported greater barriers related to medical knowledge, medication adherence, and healthcare access (p < 0.05 for all). Hispanics scored higher on the “powerful others” sub-scale (11.3 vs. 10, p < 0.05) of the MHLC. Of 177 members of the general public surveyed, Hispanics had lower stroke awareness compared to NHWs and tended to have lower awareness than Hispanic stroke patients. These results suggest that Hispanic stroke patients perceive less control over their health, experience more healthcare barriers, and demonstrate lower rates of stroke literacy. Interventions for stroke prevention and education in Hispanics should address these racial/ethnic differences in stroke awareness and barriers to risk factor control.

Research investigating the effects of exercise as therapy in cystic fibrosis (CF) has demonstrated that exercise can increase aerobic capacity (VO₂peak) and exercise tolerance [ 1 x [1] Orenstein, D.M., Franklin, B.A., Doershuk, C.F. et al. Exercise conditioning and cardiopulmonary fitness in cystic fibrosis. The effects of a three-month supervised running program. Chest. 1981; 80: 392–398 Crossref | PubMed | Scopus (142) | Google Scholar See all References ] [1] , facilitate sputum clearance [ 2 x [2] Baldwin, D.R., Hill, A.L., Peckham, D.G., and Knox, A.J. Effect of addition of exercise to chest physiotherapy on sputum expectoration and lung function in adults with cystic fibrosis. Respir Med. 1994; 88: 49–53 Abstract | Full Text PDF | PubMed | Scopus (60) | Google Scholar See all References , 3 x [3] Dwyer, T.J., Alison, J.A., McKeough, Z.J., Daviskas, E., and Bye, P.T. Effects of exercise on respiratory flow and sputum properties in cystic fibrosis. Chest. 2011; 139: 870–877 Crossref | PubMed | Scopus (49) | Google Scholar See all References ], and that individuals with CF with better aerobic fitness have better survival [ 4 x [4] Nixon, P.A., Orenstein, D.M., Kelsey, S.F., and Doershuk, C.F. The prognostic value of exercise testing in patients with cystic fibrosis. N Engl J Med. 1992; 327: 1785–1788 Crossref | PubMed | Scopus (381) | Google Scholar See all References ] [4] . Although exercise is a vital component of the therapy regimen prescribed to individuals with CF, Myers et al. demonstrated that adherence is poor, finding only 24% of adults with CF are completing their exercise program [ 5 x [5] Myers, L.B. An exploratory study investigating factors associated with adherence to chest physiotherapy and exercise in adults with cystic fibrosis. J Cyst Fibros. 2009; 8: 425–427 Abstract | Full Text | Full Text PDF | PubMed | Scopus (22) | Google Scholar See all References ] [5] . Reasons individuals with CF may not make exercise a priority are the belief that exercise is not as beneficial as pharmacological treatments, and not feeling they have the time and/or energy to engage in physical activity [ 6 x [6] Gruber, W., Orenstein, D.M., Braumann, K.M., and Beneke, R. Interval exercise training in cystic fibrosis – effects on exercise capacity in severely affected adults. J Cyst Fibros. 2014; 13: 86–91 Abstract | Full Text | Full Text PDF | PubMed | Scopus (15) | Google Scholar See all References , 7 x [7] Moola, F.J., Faulkner, G.E., and Schneiderman, J.E. “No time to play”: perceptions toward physical activity in youth with cystic fibrosis. Adapt Phys Act Q. 2012; 29: 44–62 PubMed | Google Scholar See all References , 8 x [8] White, D., Stiller, K., and Haensel, N. Adherence of adult cystic fibrosis patients with airway clearance and exercise regimens. J Cyst Fibros. 2007; 6: 163–170 Abstract | Full Text | Full Text PDF | PubMed | Scopus (36) | Google Scholar See all References , 9 x [9] Prasad, S.A. and Cerny, F.J. Factors that influence adherence to exercise and their effectiveness: application to cystic fibrosis. Pediatr Pulmonol. 2002; 34: 66–72 Crossref | PubMed | Scopus (60) | Google Scholar See all References ].