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CompletedNCT04685408TEAM-UUpdated Aug 7, 2026Results posted

A TargEted MAnageMent Intervention for Reducing Stroke Risk Factors in High Risk Ugandans

An interventional study of TEAM and ETAU in Stroke, sponsored by Case Western Reserve University. Completed at 3 sites in Uganda. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-07.

Sponsored by Case Western Reserve University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
276
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The proposed 2-phase project will first refine the TargetEd MAnageMent (TEAM) intervention to ensure acceptability across a broad range of Ugandans at risk for stroke and then test the effects of TEAM in reducing stroke risk in a 3-site, prospective, 6-month randomized controlled trial (RCT).

Read the detailed description

In Phase 1 of the project, stakeholder's advisory board (SAB) will be convened across 3 Ugandan sites. The SAB will be composed of up to 15 relevant stakeholders including 3 stroke survivors, 3 individuals with multiple stroke risk factors as defined above, 3 family members, 3 clinicians and 3 administrators who practice in the proposed study enrollment sites. The purpose of the SAB is to refine the TEAM intervention content to meet the needs of patients and professional healthcare stakeholders and suggest how TEAM might best be incorporated into clinical workflow, as well as give guidance and feedback on recruitment methods and advertisements.

Phase 2 of the project will be conducted across 3 Ugandan sites that will enroll a representative sample of Ugandans at risk for stroke (Kiruddu, Nsambya and Mbarara Hospitals and their associated outpatient clinics). In the RCT portion of the study, 246 participants will be randomized at baseline on a 1:1 basis to receive either TEAM (N= 123) or enhanced treatment as usual (ETAU) (N=123) and will be followed for a total of 6 months. Since stroke is a moderately long-term health outcome (years to decades) that typically occurs in the presence of one or more stroke risk factors, the project will focus on testing whether TEAM can modify well-established short-term biomarkers that predict stroke risk, specifically BP control, serum cholesterol and blood glucose control. Secondary outcomes of interest include additional stroke risk biomarkers, (HDL, LDL, triglycerides) diet, exercise, use of alcohol and tobacco, stroke knowledge/attitudes, stress, and treatment adherence with risk-reducing medications. We will also explore associations of age, gender, urban vs. rural residential status and stroke history (prior vs. no previous stroke) on TEAM outcomes. To help inform future scale-up should RCT findings be positive, we will assess barriers and facilitators to TEAM implementation using both qualitative and quantitative methods.

02

Conditions studied

  • Stroke

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Keywords

  • Stroke
03

In context

Stroke

7,286 studies on the registry are indexed under Stroke; 2,007 are open to participants now.

This study's enrollment of 276 is above the median of 50 across 5,369 interventional studies indexed under Stroke.

Browse Stroke studies →

Lead sponsor

Case Western Reserve University is the lead sponsor of 158 studies on the registry; 29 are open to participants now.

Of its 9 completed or terminated interventional studies of FDA-regulated products, 6 (67%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age range: ≥ 18 years
  • At risk for stroke defined by the following:

    1. High systolic BP defined as ≥ 140 mmHg assessed on at least 2 occasions at least 3 days apart and either criterion b or c as noted below:
    2. At least 1 other modifiable stroke risk factor including: diabetes, hyperlipidemia, obesity, smoking, problem alcohol use or sedentary lifestyle. Problem alcohol use for screening purposes will be assessed with questions on frequency, type of alcohol and quantity consumed. Participants will be classified as engaging in potential problem alcohol use if they exceed the recommended level for safe alcohol intake i.e. more than 3 drinks on average every time they drink, or if they undertook binge drinking (i.e. more than 3 drinks on one occasion in the one month preceding the evaluation).
    3. History of stroke or transient ischemic attack within the past 5 years
  • Able to participate in group sessions

Exclusion criteria

Exclusion Criteria:

  • Individuals who are unable or unwilling to provide written informed consent
  • Individuals who have sickle-cell disease
  • Females who are pregnant or lactating
  • Individuals with dementia
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
276 participants (actual)

Study arms

  • Experimental
    TargEted MAnageMent Intervention (TEAM)

    This arm will receive the experimental intervention, TargEted MAnageMent Intervention (TEAM)

    Behavioral: TEAM

  • Active comparator
    Enhanced treatment as usual (ETAU)

    This arm will receive the control intervention, Enhanced Treatment as Usual (ETAU).

    Behavioral: ETAU

Interventions

  • BehavioralTEAM

    TEAM is informed by principles of social cognitive theory TEAM uses nurses and peer educator dyads (PEDs) composed of patients and their care partners to co-deliver an intervention intended to help reduce future stroke risk. Team begins with one 60-minute 1:1 orientation session, in which the nurse and PED meet with the patient and his/her care partner. This is followed by 6 hour-long group sessions with 6-8 patients and their care partners held approximately weekly. The first orientation session will be done approximately 1 week post baseline, followed by group sessions were done at 2, 4, 6, 8, 10 and 12 weeks post-baseline.

  • BehavioralETAU

    ETAU will consist of an orientation visit with a nurse who will provide patient-education materials on stroke risk adapted from the American Heart Association materials and cover common risk factors such as hypertension, obesity, high salt/high fat diet and diabetes. Patients will also receive basic written information in their language of preference and tailored to the reading level of most patients at the clinic. Patients will be offered the opportunity to bring a family member with them to this visit who may also ask questions and who can assist them with understanding written materials for those with limited literacy. The nurse in ETAU will then follow-up with participants with a series of 9 brief phone calls spaced out over the course of 6 months (approximately every 2 weeks during months 1 and 2, then approximately monthly thereafter). Content will reinforce materials provided in the orientation visit and the nurse will be available to answer questions that may arise.

06

What researchers measure

Primary outcomes

  1. Change From Baseline Systolic Blood Pressure (BP) at 6 Months

    Systolic blood pressure indicates how much pressure your blood is exerting against your artery walls when the heart beats. Higher reading implies more pressure

    Time frame: Baseline and 6 months

07

Results

Posted Aug 3, 2025

Participant flow

Participant flow — Overall Study
MilestoneTargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer Educators"Phase 2: TargEted MAnageMent Intervention (TEAM) - Peer Educator Care Partners
Started1221251577
Completed1131121577
Not completed913000

Outcome measures

PrimaryChange From Baseline Systolic Blood Pressure (BP) at 6 Months

Systolic blood pressure indicates how much pressure your blood is exerting against your artery walls when the heart beats. Higher reading implies more pressure

Time frame:
Baseline and 6 months
Reported as:
Mean · millimeters of mercury (mmHg)
Change From Baseline Systolic Blood Pressure (BP) at 6 Months
millimeters of mercury (mmHg)TargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)
Baseline145.7 ± 21.5141.9 ± 18.4
6-months137.4 ± 18.1141.1 ± 21.9

Adverse events

Collected over 6 months. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
TargEted MAnageMent Intervention (TEAM)2/122 (1.6%)1/122 (0.8%)0/122 (0%)
Enhanced Treatment as Usual (ETAU)1/125 (0.8%)0/125 (0%)0/125 (0%)
Phase 1 Stakeholders0/15 (0%)0/15 (0%)0/15 (0%)
Phase 2: TargEted MAnageMent Intervention (TEAM) - Peer Educators0/7 (0%)0/7 (0%)0/7 (0%)
"Phase 2: TargEted MAnageMent Intervention (TEAM) - Peer Educator Care Partners0/7 (0%)0/7 (0%)0/7 (0%)
Most frequent serious events
Most frequent serious events
EventTargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer Educators"Phase 2: TargEted MAnageMent Intervention (TEAM) - Peer Educator Care Partners
SepsisGeneral disorders1/1220/125———

Baseline characteristics

Employment status, residency status and family stroke history were not collected on Phase 1 Stakeholders, Phase 2: TargEted MAnageMent Intervention (TEAM) - Peer Educators or Phase 2: TargEted MAnageMent Intervention (TEAM) - Care Partners. We also did not collect marital status or education status on Phase 2: TargEted MAnageMent Intervention (TEAM) - Care Partners.

Age, Continuous
Age, Continuous(years)TargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer EducatorsPhase 2: TargEted MAnageMent Intervention (TEAM) - Care PartnersTotal
Mean55.2 ± 11.655.7 ± 12.550.6 ± 13.4151.6 ± 1239.4 ± 14.855.4 ± 12.0
Sex: Female, Male
Sex: Female, Male(Participants)TargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer EducatorsPhase 2: TargEted MAnageMent Intervention (TEAM) - Care PartnersTotal
Female8484951183
Male384162491
Race (NIH/OMB)
Race (NIH/OMB)(Participants)TargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer EducatorsPhase 2: TargEted MAnageMent Intervention (TEAM) - Care PartnersTotal
American Indian or Alaska Native000000
Asian000000
Native Hawaiian or Other Pacific Islander000000
Black or African American1221251577276
White000000
More than one race000000
Unknown or Not Reported000000
Region of Enrollment
Region of Enrollment(Participants)TargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer EducatorsPhase 2: TargEted MAnageMent Intervention (TEAM) - Care PartnersTotal
Uganda1221251577276
Educational Level
Educational Level(Participants)TargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer EducatorsPhase 2: TargEted MAnageMent Intervention (TEAM) - Care PartnersTotal
None10800—18
Primary516711—120
Secondary513671—95
Tertiary101475—36
Marital Status
Marital Status(Participants)TargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer EducatorsPhase 2: TargEted MAnageMent Intervention (TEAM) - Care PartnersTotal
Single7820—17
Married7656115—148
Separated/Divorced/Widowed396122—104
Currently employed/working
Currently employed/working(Participants)TargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer EducatorsPhase 2: TargEted MAnageMent Intervention (TEAM) - Care PartnersTotal
Count of participants8279———161
Residency Status
Residency Status(Participants)TargEted MAnageMent Intervention (TEAM)Enhanced Treatment as Usual (ETAU)Phase 1 StakeholdersPhase 2: TargEted MAnageMent Intervention (TEAM) - Peer EducatorsPhase 2: TargEted MAnageMent Intervention (TEAM) - Care PartnersTotal
Rural2528———53
Urban4962———111
Suburban4835———83

1 further baseline measures are reported on the registry.

08

Study locations

3 sites
  • Mulago Hospital
    Kampala, Uganda
  • Nsambya Hospital
    Kampala, Uganda
  • Mbarara Regional Referral Hospital
    Mbarara, Uganda
09

References and documents

Publications

  • Sajatovic M, Kaddumukasa M, Najjuma JN, Mbalinda SN, Nakibuuka J, Birungi D, Conroy C, Yala J, Mugenyi L, Burant CJ, Moore S, Katabira ET, Kaddumukasa M. Demographics and Clinical Correlates of Blood Pressure Among Ugandans at Risk for Stroke. J Neurol Res. 2024 Dec;14(2):74-85. doi: 10.14740/jnr830. Epub 2024 Nov 15. PubMed 41835484 ↗
  • Kaddumukasa M, Kaddumukasa M, Mbalinda SN, Najjuma J, Nakibuuka J, Birungi D, Conroy C, Yala J, Mugenyi L, Burant CJ, Moore S, Katabira ET, Sajatovic M. A 6-month, prospective randomized controlled trial of the TargetEd MAnageMent (TEAM) intervention vs. enhanced treatment as usual among Ugandans at risk for stroke. PLoS One. 2025 Aug 22;20(8):e0330606. doi: 10.1371/journal.pone.0330606. eCollection 2025. PubMed 40844998 ↗
  • Kaddumukasa M, Najjuma J, Mbalinda SN, Kaddumukasa MN, Nakibuuka J, Burant C, Moore S, Blixen C, Katabira ET, Sajatovic M. Reducing stroke burden through a targeted self-management intervention for reducing stroke risk factors in high-risk Ugandans: A protocol for a randomized controlled trial. PLoS One. 2021 Jun 22;16(6):e0251662. doi: 10.1371/journal.pone.0251662. eCollection 2021. PubMed 34157024 ↗

Study documents

  • Protocol and statistical analysis plan · Mar 20, 2024

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — The final dataset will include self-reported demographic and behavioral data from interviews with the subjects' data. The final dataset will be stripped of identifiers prior to release for sharing; we believe that there remains the possibility of deductive disclosure of subjects with unusual characteristics. Thus, we will make the data and associated documentation available to users only under a data-sharing agreement (national and international are required) that provides for: (1) a commitment to using the data only for research purposes and not to identify any individual participant; (2) a commitment to securing the data using appropriate computer technology; and (3) a commitment to destroying or returning the data after analyses are completed. Beyond this all the information generated from the various study data sets will be made available to the global community in open access journals indexed in pub med or via the internet as described in the dissemination plan.

Supporting information: Study protocol

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 7, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04685408
Lead sponsor
Case Western Reserve University
Collaborators
National Institute of Neurological Disorders and Stroke (NINDS), Fogarty International Center of the National Institute of Health
Responsible party
Martha Sajatovic, MD (Professor, Case Western Reserve University) — Principal investigator
First posted
Dec 28, 2020
Start date
May 13, 2022
Primary completion
Mar 6, 2024
Completion
Sep 3, 2024
Results posted
Aug 3, 2025
Last update
Aug 7, 2026

Study contacts

Marta Sajatovic, MD
principal investigator · Case Western Reserve University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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