Homecare community team to reduce social barriers and improve stroke recovery

The SDOH-Homecare Intervention Focus Team (SHIFT) Trial to Mitigate SDOH in Stroke Outcomes and Build Community Capacity

NIH-funded research Columbia University Health Sciences · NIH-11380500

This program offers a home-based team of a community health worker, nurse, and social worker to help adults recovering from stroke who face multiple social needs improve function and blood pressure.

Quick facts

Grant typeU01 cooperative agreement
Study typeNIH-funded research
Funding institutionColumbia University Health Sciences NIH-funded
Lab location1 site (New York, United States)
Project IDNIH-11380500 on NIH RePORTER

What this research studies

If you join, you would be randomly assigned to receive the SHIFT homecare team or usual care after hospital discharge. The SHIFT team pairs a community-based organization (CBO)-affiliated community health worker with a community nurse and a social worker to address social needs, coordinate care, and connect you to services. The trial focuses on adults with more than three social determinants of health (SDOH) risk factors and follows functional recovery and physiological outcomes like blood pressure over time. The team works at the community, health system, interpersonal, and individual levels to reduce barriers such as housing, food, transportation, and access to care.

Who could benefit from this research

Good fit: Adults aged 21 and older recently hospitalized for stroke who have more than three social risk factors and can receive home visits are ideal candidates.

Not a fit: People without a recent stroke, those with few or no social risk factors, or those unable to receive home-based services are unlikely to benefit from this program.

Why it matters

Potential benefit: If successful, this approach could help people recover better after stroke and improve blood pressure control by directly addressing social needs at home.

How similar studies have performed: Previous work shows community health workers, homecare, and social support can improve chronic disease management, but this combined multi-level SHIFT approach for post-stroke recovery is novel and being formally tested.

Where this research is happening

New York, United States

Researchers

About this research

  1. This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
  2. Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
  3. For full project details, budget, and progress reports, visit the official NIH RePORTER page below.
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.