SaFaRI is a prospective longitudinal follow-up study based on a cluster-randomized controlled trial (System-integrated technology-enabled model of care to improve the health of stroke patients in rural China, SINEMA study) to evaluate the effectiveness of the SINEMA model to improve the secondary prevention of stroke in Nanhe County, a rural area of Hebei Province, China. A total of 1299 stroke patients were included at baseline, of which 25 villages received the SINEMA intervention package.~The SaFaRI study will conduct a new round of follow-up visit for participants of the SINEMA trial. In addition to the 1299 stroke patients included at baseline, this follow-up will also include the stroke patients' spouses. The specific objectives of this study are to 1) evaluate blood pressure reduction, adherence to secondary prevention medications, physical activity, stroke recurrence, hospitalization, and death of stroke patients, (2) examine the long-term effectiveness of the SINEMA intervention model post 5-year follow-up by evaluating the knowledge attitude and practice in delivering the secondary prevention of village doctors , and 3) establish a dynamic and continuous cohort of stroke patients with characteristics of northern rural China based on the data collection of the baseline survey and the 1-year follow-up visit.
SaFaRI is a large prospective cohort study in Hebei Province, rural Northern China including 1,299 stroke patients and their spouses. Follow-up visits take place from baseline until the fifth year after the baseline survey, investigating the lifestyle and health behavior, disease history, medication and adherence to medication, health status and self-reported health, cognitive function, and medication cost. As additional measures, the investigators will collect information on hospitalization, recurrence, and vital status from county medical insurance system and death record system. Patients will also have a physical examination comprising of assessment of blood pressure, weight, height, waist circumference, neck circumference, grip strength and the Timed Up and Go test.