REDUCING THE RISK AND ECONOMIC BURDEN OF RECURRENT STROKE BY IMPROVING MEDICATION ADHERENCE USING A NOVEL SMART PILL CONTAINER, CAP, AND HEALTH LITERACY TECHNOLOGIES - STROKE IS THE LEADING CAUSE OF DEATH AND DISABILITY WORLDWIDE WITH THE STRONGEST DISPARITY IN STROKES SEEN IN BLACK MIDDLE-AGED PERSONS. BLACK PERSONS HAVE INCIDENCE RATES OF ISCHEMIC STROKE THAT ARE 2- TO 3-FOLD HIGHER THAN WHITES. ADDITIONALLY, OVER 80% OF STROKE SURVIVORS WILL HAVE IMMEDIATE AND PERSISTENT WEAKNESS OF THEIR UPPER LIMB, LEAVING HALF OF THE PERSONS WITH A CHRONIC DISABILITY AND INABILITY TO COMPLETE SIMPLE AND BASIC MANUAL DEXTERITY ACTIVITIES, INCLUDING TAKING MEDICATIONS AS PRESCRIBED (MEDICATION ADHERENCE). THE GREATEST AREAS WHERE STROKE SURVIVORS NEED HELP ALL OF THE TIME WAS IN TAKING MEDICINES OUT OF A BOX, PACKET OR BOTTLE, WITH REMAINING SUPPORT NEEDED IN MANAGING PRESCRIPTIONS, RECEIVING ALERTS OF MEDICATION DOSING TIMES, SWALLOWING MEDICINES, AND (D) REMEMBERING IF A MEDICATION WAS TAKEN. CURRENT COMPETITORS HAVE SIGNIFICANT DESIGN BARRIERS THAT LIMIT ACCESS TO DISABLED PERSONS, MEDICATION SAFETY, AND SOCIAL DETERMINANTS OF HEALTH (SDOH). ACCURATE ADHERENCE MONITORING REQUIRES DETERMINING WHETHER MORBIDITY AND MORTALITY ARE A RESULT OF FULL OR PARTIAL COMPLIANCE OR PERSISTENT USE OF MEDICATION. MULTIPLE SENSORS SHOULD BE ATTACHED TO THE PILL BOTTLE TO DETECT AND MONITOR MEDICATION ADHERENCE TO IMPROVE ACCURACY OF DETECTING PARTIAL COMPLIANCE, PERSISTENT USE, AND DETERMINING CORRELATES OF STROKE-RISK REDUCTION OUTCOMES. SANO'S NOVEL PHARMACY ENVIRONMENTAL INTERACTIVE DEVICE (EID) PROTOTYPE IS DESIGNED TO ELIMINATE HEALTH DISPARITIES BY PREVENTING CARDIOVASCULAR COMPLICATIONS IN STROKE SURVIVORS BY OVERCOMING MANY OF THESE BARRIERS TO MEDICATION ADHERENCE. SANO'S NOVEL AND PATENTABLE EID IS DESIGNED FOR (A) SINGLEHAND USE IN STROKE SURVIVORS (DISABILITY SOLUTION); (B) DUAL IN-HOME DOSING ALERT AND ADHERENCE MONITORING SYSTEM BY MEASURING PILL WEIGHT AND SMART CONTAINER MANIPULATION (MEDICATION SAFETY/ADHERENCE); (C) USE OF A CARDIOVASCULAR TAXONOMY CLASSIFICATION SYSTEM DESIGNED FOR CULTURALLY SENSITIVE AND PREFERRED HEALTH LITERACY LANGUAGE (HEALTH LITERACY); (D) A REUSABLE SMART CONTAINER AND CAP FOR USE WITH LOW-COST CARDIOVASCULAR MEDICATIONS (SOCIAL DETERMINANTS OF HEALTH). SANO'S ADDITIONAL ENGINEERING INNOVATION WILL ALSO TEST TWO TYPES OF STRAIN GAUGE SENSORS (METAL ALLOY AND GRAPHENE NANOSHEETS SYNTHESIZED USING A WATER- ASSISTED LIQUID PHASE EXFOLIATION), THEREBY EXPANDING THE COMMERCIAL LOAD CELL FAMILY OF MATERIALS TO INCLUDE STRAIN GAUGES AS A VALUE-BASED IN-HOME PRESCRIPTION SCALE. FUTURE HEALTH INNOVATIONS AND INTERVENTIONS MUST TARGET THE POPULATION AT RISK, THE NUMBER OF PERSONS TRULY AT RISK RELATIVE TO THE SIZE OF THE TARGET GROUP, BE COST-EFFECTIVE IN PREVENTION AND TREATMENT, AND BE CULTURALLY SENSITIVE TO IMPROVE INTERVENTION USE IN THE TARGETED POPULATION.