SINEMA Model of Care to Improve the Health of Stroke Patients in Rural China

The SINEMA trial is a cluster-randomized controlled trial to evaluate the effectiveness of implementation of a system-integrated and technology-enabled model of care to improve the secondary prevention of stroke in Nanhe County, a rural area of Hebei province, China. Fifty villages from five townships are stratified randomized in a 1:1 ratio to either the intervention arm (implementing SINEMA model) or the control arm (usual care).

After a baseline survey, intervention will be implemented in 25 intervention villages, lasting for 12 months. Follow-up survey will be conducted in the same way in all villages at 12-month after the initial of the study. Process evaluation will be conducted every three month, and economic evaluation will also be conducted.

Inclusion criteria

those who

• are aged more than 18 years old;
• have a history of stroke (including ischemic and hemorrhagic stroke) diagnosed at county hospital or higher-level facilities, and currently in a clinically stable condition and not receiving acute stroke treatment;
• will live in this village for at least nine months during the next 12 months;
• have a basic communication ability (i.e. can understand simple instructions);
• give participant informed consent and are willing to participate in the study.

Exclusion criteria

those who

• are unable to get out of bed without maximum assistance;
• have serious life-threatening disease such as cancers;
• who have an expected life span of less than 6 months.