Abstract DP012: Targeted Community Outreach as a Scalable Strategy to Reduce Stroke Presentation Delays in High-Disparity Populations

Background: Early stroke recognition and prompt EMS activation are essential for reperfusion therapies. Yet, many underserved and linguistically diverse communities face barriers that delay presentation, limiting treatment opportunities. Objective: To evaluate whether a data-driven outreach program, designed around cultural and language needs, could shorten last known well (LKW) to hospital arrival times and improve treatment access. Methods: At a large U.S. comprehensive stroke center, FY 2023 baseline data showed a median LKW to arrival time of 266 minutes, well above the national benchmark of 228 minutes. Zip code mapping identified neighborhoods with the longest delays and lowest EMS use. These areas were predominantly Hispanic and Spanish-speaking. Beginning in FY 2024, all stroke admissions (FY 2024: n=1125; FY 2025: n=1071) were reviewed quarterly by zip code, race/ethnicity, arrival mode, and treatment rates. Outreach events focused on high-delay areas and used bilingual educators along with Spanish-language materials tailored to community needs. Results: Median LKW to arrival improved to 214 minutes in FY 2024, a 52-minute or 19.5% reduction from baseline. In FY 2025, the median was 232 minutes, a 34-minute or 12.8% reduction. EMS utilization and treatment rates also rose, with the most pronounced gains among Spanish-speaking Hispanic patients. Areas that received repeated outreach events showed consistent improvements, while delays tended to rise when outreach was less frequent, suggesting a dose–response effect. Conclusion: A focused outreach program, built around bilingual education and cultural relevance, reduced delays in stroke presentation by nearly 20% and improved access to acute treatment in underserved Hispanic communities. This approach is practical, data-driven, and adaptable to other populations where disparities in stroke care remain.