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. 2025 Nov 1;28(6):863-870.
doi: 10.4103/aian.aian_933_24. Epub 2025 May 19.

Educational and Socioeconomic Correlates of Stroke Risk Behaviors: Findings from the SPRINT INDIA Trial

Shweta Jain Verma  1 , Gurnoor Kaur  2 , Arya Devi  1 , Deepti Arora  1 , Aneesh Dhasan  3 , P N Sylaja  3 , Dheeraj Khurana  4 , Vijaya Pamidimukkala  5 , Biman Kanti Ray  6 , Vivek Nambiar  7 , Sanjith Aaron  8 , Gaurav Mittal  9 , Sundarachary Nagarjunakonda  10 , Aparna R Pai  11 , Sankar Prasad Gorthi  11 , Somasundaram Kumaravelu  12 , Yerasu Muralidhar Reddy  13 , Sunil Narayan  14 , Nomal Chandra Borah  15 , Rupjyoti Das  15 , Girish Baburao Kulkarni  16 , Vikram Huded  17 , Thomas Mathew  18 , Mv Padma Srivastava  19 , Rohit Bhatia  19 , Pawan Kumar Ojha  20 , Jayanta Roy  21 , Sherly Mary Abraham  22 , Anand Girish Vaishnav  23 , Arvind Sharma  24 , Sheikh Jabeen  25 , Abhishek Pathak  26 , Sanjeev Kumar Bhoi  27 , Sudhir Sharma  28 , Sulena Sulena  29 , Aralikatte Onkarappa Saroja  30 , Neetu Ramrakhiani  31 , Madhusudhan Byadarahalli Kempegowda  32 , Mahesh Kate  33 , Tina George  8 , Ivy Sebastian  9 , Meenakshi Sharma  34 , Rupinder Dhaliwal  34 , Rahul Huilgol  1 , Jeyaraj D Pandian  1
Affiliations
Free article

Educational and Socioeconomic Correlates of Stroke Risk Behaviors: Findings from the SPRINT INDIA Trial

Shweta Jain Verma et al. Ann Indian Acad Neurol. .
Free article

Abstract

Background and objectives: Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) trial was a randomized control trial that enrolled 4298 stroke patients and administered educational interventions at 31 centers across India, with the aim to reduce recurrent stroke through increased stroke knowledge. This SPRINT INDIA trial post hoc study aims to investigate the incidence of recurrent stroke, high-risk transient ischemic attack (TIA), acute coronary syndrome (ACS), death, and lifestyle behavioral factors at 1 year. In addition, it examines the relationship between patients' baseline characteristics and education levels, risk factors, and outcomes and performs subgroup analysis within the intervention and control groups.

Methods: Participants were randomly assigned (1:1) to either intervention or control group through computer-based randomization on web. Intervention included stroke prevention Short Message Service messages, short-duration videos, and printed workbooks. Baseline assessments captured demographic and educational data, classifying patients into three categories: no schooling, less than high school, and high school or above. Primary outcome was a composite of recurrent stroke, high-risk TIA, ACS, and mortality at 1 year. Chi-square tests and analysis of variance were used to evaluate educational disparities across various variables.

Results: The intervention did not reduce primary outcomes at 1 year among patients with different educational levels. Higher educational group was associated with enhanced medication adherence (94.3% vs 85.4%; P < 0.001), increased physical activity (5497.91 ± 4117.7 vs 6169.91±4828.8; P < 0.001), lower triglyceride levels, and decreased engagement in behavioral risk factors like alcohol intake (5.1% vs 6.8%; P = 0.013) and tobacco use (smoked and chewed) (4% vs 7.9%; P < 0.001 and 5.8% vs 11.6%; P = 0.020).

Conclusions: Personalized secondary stroke prevention, tailored to educational levels, is crucial for effective stroke management.

Keywords: Stroke; education; outcomes; recurrent stroke; risk factors.

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