Cognitive Strategies for Optimizing Brain Health And Managing Transgenerational Vascular Risk Factors Post-Stroke

People living with the cognitive effects of stroke are at risk for recurrent stroke and further cognitive decline. Also problematic is that stroke risk clusters in families and biological family members of people who have ischemic stroke may also be at increased risk of stroke and/or cognitive decline. The primary goal of this study is to test the feasibility of a virtually delivered cognitive strategy training and health coaching program to reduce vascular risk and promote brain health in persons with stroke and their biological family members.

Inclusion Criteria: 1. primary diagnosis of acute ischemic stroke, 2. impairment of cognitive function (score \>1 on Quick Executive Interview - telephone screener), 3. absence of severe aphasia (score of 0 or 1 on NIH Stroke Scale), 4. absence of pre-stroke dementia (client report), 5. absence of major anxiety and depressive disorder (PHQ-9, GAD-7), 6. absence of drug and alcohol misuse within 3 months of study (AUDIT, DAST), 7. greater than 40 years of age, 8. having a potential family member who meets targeted family member criteria, 9. eligible for MRI and Remote Supervised-transcranial direct current stimulation (RS-tDCS) if in CHAMPS-TR plus RS-tDCS (e.g., not pregnant; no intracranial metal implants; no skin lesions on target sites for stimulation; no severe cardiopulmonary, renal or hepatic diseases; no pacemakers; no underlying medical reason for not engaging in MRI or tDCS). The targeted family member will be: 1. a minimum of 18 years of age, 2. biological kin of person with stroke, 3. absence of dementia (client report), 4. absence of major anxiety and depressive disorder (PHQ-9, GAD-7), 5. absence of drug and alcohol misuse within 3 months of study (AUDIT, DAST), 6. greater than 18 years of age, and 7. having a sibling or parent who had an ischemic stroke Exclusion Criteria: For all participants: 1. not English speaking, reading, and understanding, and 2. no access to video-conference software on a computer or smart device