BACKGROUND: Racial/ethnic minority older adults have worse stroke burden than non-Hispanic white and younger counterparts. Our academic-community partner team tested a culturally tailored 1-month (8-session) intervention to increase walking and stroke knowledge among Latino, Korean, Chinese, and black seniors. METHODS AND RESULTS: We conducted a randomized wait-list controlled trial of 233 adults aged 60 years and older, with a history of hypertension, recruited from senior centers. Outcomes were measured at baseline (T0), immediately after the 1-month intervention (T1), and 2 months later (T2). The primary outcome was pedometer-measured change in steps. Secondary outcomes included stroke knowledge (eg, intention to call 911 for stroke symptoms) and other self-reported and clinical measures of health. Mean age of participants was 74 years; 90% completed T2. Intervention participants had better daily walking change scores than control participants at T1 (489 versus -398 steps; mean difference in change 887; 97.5% CI 137 to 1636), but not T2 after adjusting for multiple comparisons (233 versus -714; mean difference in change 947; 97.5% CI -108 to 2002). The intervention increased the percent of stroke symptoms for which participants would call 911 (from 49% to 68%); the control group did not change (mean difference in change T0 to T1 = 22%; 99.9% CI 9 to 34%). This effect persisted at T2. The intervention did not affect measures of health (eg, blood pressure). CONCLUSIONS: This community-partnered intervention did not succeed in increasing and sustaining meaningful improvements in walking levels among minority seniors, but it caused large, sustained improvements in stroke preparedness. CLINICAL TRIAL REGISTRATION: URL http://www.ClinicalTrials.gov. Unique identifier NCT02181062.

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