Key result
Rural outreach education is linked to a ~146% increase in thrombolysis rates across racial groups.
Why the study?
Racial and age-related disparities in stroke incidence and treatment access remain significant in rural states.
Does rural outreach education combined with telestroke services increase the utilization of intravenous thrombolytics across different racial and age groups in rural populations?
Does rural outreach education combined with telestroke services increase the utilization of intravenous thrombolytics across different racial and age groups in rural populations?
Targeted rural stroke awareness campaigns paired with telestroke services are associated with substantially increased thrombolysis rates across all racial groups.
Hypothesis-generating for rural outreach in stroke systems; extends observational data on access but requires prospective trials before practice change.
Background: Racial and age-related disparities in stroke incidence and treatment access remain significant in rural states. Since 2019, the UAMS Institute for Digital Health&Innovation (IDHI) Telestroke Program has expanded targeted stroke awareness and outreach in rural Arkansas, focusing on high-burden, underserved populations. The program provides 24/7 vascular neurology expertise through a statewide hub-and-spoke network, enabling rapid thrombolytic treatment at hospitals without on-site stroke specialists. Methods: We retrospectively analyzed telestroke consults treated with intravenous thrombolytics from 2019–2024, stratified by race (African-American, White, Hispanic, Asian), gender, and median age. Outreach included community education events, EMS training, and hospital workflow optimization in rural regions. Results: From 2019–2024, lytic-treated African-American patients increased from 41 to 101 (+146%), with median ages 58–63 years. White patients increased from 265 to 655 (+147%), median ages 67–69 years. Hispanic patients rose from 1 to 13 (+1200%), median ages 46–74 years. Asian patients comprised 0–3 annually. Across all years, African-American and Hispanic patients were treated at younger median ages than White patients; for 2020–2024, age differences between races were statistically significant (F=16.42, p<0.0001). Mean ages also differed significantly by gender across races (p=0.0009), with variation in direction and magnitude by race group. Conclusions: Rural stroke awareness campaigns coincided with increased thrombolysis across all racial groups, with particularly notable gains among African-American and Hispanic patients. Pairing telestroke services with targeted community outreach may improve equity in acute stroke care by fostering earlier hospital arrival and greater access to time-sensitive interventions.
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Brown et al. (2026) studied this question. Rural outreach education increased thrombolysis rates by 146% in African-American and 147% in White patients, highlighting improved access to stroke care.
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