Our Work

System-Integrated Technology-Enabled Model of Care Aiming to Improve the Health of Stroke Patients in Resource-Poor Settings in China (The SINEMA Study)

Project Objectives

**Study Aim:**
The principal research question is: Can trained village doctors and family caregivers, equipped with digital health technology, provide
essential evidence-based care to stroke survivors in rural China?

The specific aims are:

1. To conduct a barriers analysis to understand the opportunities and constraints experienced by stroke patients and their families in
accessing essential healthcare delivery for stroke patients
2. To assemble and integrate each component of the SINEMA model piloted in previous studies into a holistic model of practical,
scalable and seamless essential healthcare delivery for stroke patients
3. To implement the SINEMA model in a resource-poor rural area in China and evaluate its impact on the primary outcome of
systolic blood pressure and a number of secondary outcomes.

**Study Design and methods:**
The SINEMA study is a cluster randomized trial designed to improve essential evidence-based care to stroke survivors in rural China
through equipping village doctors and family caregivers with training and digital health technology. With a plan to involve village
doctors, more than 1,250 stroke patients and family caregivers, the study will be conducted in 50 villages in Nanhe county of Hebei
Province, an area within the "stroke belt" in China.

Project Outcomes

We have conducted around 30 patients and healthcare providers' interview as part of the contextual research to understand the opportunities and constrains experienced by stroke patients and village doctors.

We are working on the design of the protocol and intervention. An android-based application for village doctors on collecting data during routine patients' visits is developed. A pilot study on 62 patients in 4 villages will be conducted in January in 2017.

Project Policy Impact Description

The impact of SINEMA Trial is expected to reverberate throughout the patient population, healthcare system, industry and government.
This study has the potential to extend its influence beyond China, and to other low- and middle-income countries searching for effective and low-cost population solutions to the burden of non-communicable disease.




  • Wellcome Trust


  • Duke Kunshan University
  • Duke University
  • Beijing Tiantan Hospital

Project Status


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