Abstract Body: Background and Purpose
Historically disadvantaged and marginalized communities experience greater obstacles to health, higher stroke risk, and poorer stroke outcomes. Social determinants of health factors and experiences of discrimination have been linked to stroke risk, but more research is needed to understand the prevalence and the impact of experiences of discrimination for individuals with stroke. The purpose of this study is to estimate the proportion of individuals with stroke who report experiences of discrimination and to determine which patients are more likely to report everyday discrimination and discrimination in the healthcare setting.

Methods
In this descriptive analysis, we evaluated 445 patients with a TIA, ischemic stroke, or hemorrhagic stroke who were enrolled in the randomized clinical trial, VIRTUAL (Video-based Intervention to Reduce Treatment and Outcome Disparities in Adults Living with Stroke or TIA) from March 29, 2022 to September 26, 2024. Reported experiences of everyday discrimination (EDD) or discrimination in the healthcare setting (HCD) were measured using validated perceived discrimination scales. Reported discrimination (score > 0) compared to no discrimination (score = 0) were compared across a distribution of sociodemographic variables including age, sex, race, ethnicity, language preference, educational attainment, and insured status.

Results
EDD was reported in 92/435 (21.1%) of participants, while HCD was reported in 40/439 (9%). Reported EDD did not vary by age, sex, race, language preference, educational attainment, or insured status; however, there was a signal of higher EDD in patients of Hispanic vs non-Hispanic ethnicity (27% vs 18.5%, p= 0.056). Reports of HCD were higher in female vs male (12% vs 6.4%, p= 0.048) and non-English speaking patients (11.3% Spanish and 100% Other vs 8.7% English speaking, p <0.005). Reports of HCD also varied by race (37.5% Asian, 6.9% Black, 7.9% White, and 19% Other reported race; p <0.005).

Conclusion
This analysis of a diverse cohort of stroke patients shows differences in reports of EDD vs HCD. Sociodemographic factors were not associated with EDD; however, there was a trend for more EDD reports by ethnicity (Hispanic). HCD was associated with several sociodemographic factors. Further investigation is needed to determine whether this reflects experiences across multiple communities and to what extent these experiences of HCD influence stroke risk, care, and outcomes.