Abstract Body: Introduction: Stroke represents a major global public health challenge, with 12.2 million new cases, 6.5 million deaths, and over 143 million disabilities occurring annually, leading to significant economic and social repercussions. Structural racism deleteriously influences stroke care and outcomes, making it essential to integrate multicultural considerations throughout the stroke care continuum to enhance outcomes and reduce disparities. A document analysis was conducted to assess the extent to which stroke guidelines address cultural diversity in stroke care.
Method: A document review of international stroke guidelines was employed based on the framework established by Steinberg et al. A Google search was conducted to identify international stroke care guidelines published in English within the last five years (2019 – 2024). The quality of these guidelines was assessed using the Appraisal of Guidelines for Research & Evaluation (AGREE-II) tool. Paired reviewers independently screened the guidelines and identified recommendations related to multicultural stroke care, defined as ‘practices aimed at ensuring care delivery is culturally competent, sensitive, safe, equitable, and adaptable’.
Results: A total of twenty-five guidelines were included, with the majority originating from Western countries such as Australia, the United States, the United Kingdom, Canada, and various European societies. Only four of the twenty-five guidelines explicitly addressed multicultural considerations. Most of the recommendations were based on low levels of evidence or consensus and related to dietary and cultural considerations, and the management of diverse patient needs in stroke care.
Conclusion: A paucity of recommendations for multicultural considerations in stroke care were identified. Current stroke care guidelines fail to address multiculturalism adequately, which may reflect the maturity of the available evidence to inform guideline recommendations. Further research is needed to identify enablers and barriers to incorporating multicultural considerations in stroke care and the development of future guidelines. New evidence is needed in this regard to improve clinical outcomes of diverse populations.