Our flagship NIH-funded research project is DISPLACE: Dissemination and Implementation of Stroke Prevention Looking at the Care Environment.

Project Rationale

Since sickle cell disease (SCD) carries an increased risk for ischemic stroke, stroke prevention in this patient population is vital. To this end, the 2014 NHLBI guidelines specify that children with SCD—specifically those with genotype hbSS or hbSB0—should be screened annually with Trans-Cranial Doppler (TCD) beginning at two years of age and continuing until age 16.

TCD works by measuring the speed of blood in the blood vessels in the brain. If the blood is too fast, it indicates the blood vessel is abnormal and the child is at increased risk of stroke. In the event that of an abnormal result, children should begin chronic red cell transfusion therapy (CRCT) to decrease their risk of stroke.

While the guidelines are clear, the screening doesn’t happen as often as it should. Therefore, it is critical to identify and adopt effective dissemination and implementation strategies to increase compliance with the guidelines and improve outcomes for patients with SCD.

Project Goals

• To assess the gap between current and recommended evidence-based practice for stroke prevention in children with SCD

• To evaluate the effectiveness of a novel multi-level dissemination and implementation strategy targeting providers, patients, and healthcare systems to enhance implementation of annual TCD screening and CRCT initiation in at-risk patients with SCD at selected consortia institutions in order to achieve a “stroke free generation”

Project Plan

We are currently evaluating novel strategies to improves stroke screening for children with sickle cell anemia. We are using a parallel, randomized cluster controlled study to evaluate the impact of implementation methods that harness current technology including a novel application. 

The study is currently scheduled for completion in December 2021 and we hope to present data at that time.

The Data Coordination Unit at Medical University of South Carolina, housed within the Department of Public Health Sciences, will oversee the data management for DISPLACE. All trial management activities are housed within the Clinical Trials Management System referred to as the WebDCU™ system. WebDCU™ will also house the meeting minutes, publications and other consortium-member specific items.

Access the WebDCU™ system available via the link below:

Consortium Member Login