A few of the trials showed improvement in second- ary outcomes or subpopulations. The SUSTAIN trial (Systemic Use of Stroke Averting Interventions) of a culturally tailored Chronic Care Model based inter- vention (incorporating advance practice provider delivery of evidence-based care, protocols, real- time decision support, self-management support, and education) in a multiracial/multiethnic popula- tion in a safety-net setting showed better LDL con- trol (secondary outcome) in the intervention arm; intervention participants were more likely to lower LDL <100 md/dL compared with control subjects In the PRAISE trial (Prevent Recurrence of All Inner-City Strokes Through Education) of peer-led community-based poststroke self-management workshops in the inner city, the primary composite outcome of BP, LDL, and antithrombotic use at 6 months was not different in the intervention and control arms, but a higher proportion of those randomized to the inter- vention had controlled BP at 6 months (76% ver- Finally, a subgroup analysis of Hispanic individuals enrolled in the DESERVE trial (Discharge Educational Strategies for Reduction of Vascular Events), evaluating the efficacy of a cul- turally tailored skills-based intervention, revealed a 9.9 mmHg greater reduction in SBP compared Knowledge Gaps and Future Research Numerous RCTs of culturally tailored complex secondary stroke prevention interventions in populations at high risk for inequities have failed to show a clear improvement in primary outcomes compared with usual care. Further research is needed to determine optimal strategies for reducing inequities in risk factor control after stroke. Key populations at risk for inequities include those from Black, Hispanic, and indigenous backgrounds; women; the elderly; immigrants; lesbian, gay, bisexual, transgen- der, and queer or questioning individuals; and those with low income, low educational attainment, limited English proficiency, unstable housing, inadequate social sup- port, concurrent substance abuse, comorbid psychiatric illness, or history of incarceration. 