231 Development and Psychometric Properties of the Stroke Assessment and Treatment Intent Scale

Abstract

The only known psychometrically validated tool for measuring stroke awareness is the stroke action test (STAT), a 28-item scale that asks respondents to associate symptoms with appropriate actions (ie, “call 911”). A significant limitation of this test is that the correct action includes an option other than “calling 911” in the event of stroke. Additionally, there are no questions that assess a respondent’s awareness of thrombolytic therapy. This study sought to create an updated, validated instrument with psychometric properties to measure public stroke knowledge. A 44-item scale was developed and included questions measuring: (1) knowledge of stroke symptoms; (2) general stroke awareness; (3) knowledge to call 911 in the event of a stroke; and, (4) the STAT. Patients at least 18 years of age presenting to a tertiary care, academic emergency department (ED) were approached by trained research assistants in this prospective, cross-sectional study. Surveys were also distributed to college students at the affiliated academic research university. The scale was subjected to factor analysis with Promax Rotation to create a final condensed instrument and Cronbach’s alpha was used to assess internal consistency. SAS software was used for all analyses. The mean age of the 455 respondents was 36.9 years, with significantly more females (61.4%). The factor analysis of the 44-item scale yielded a final 20-item Stroke Awareness and Treatment Intent (SATI) scale that consisted of 3 subscales- “knowledge to call 911” (α=0.806), “knowledge of stroke symptoms” (α=0.922), and “general stroke awareness” (α=0.723). Both the STAT and the SATI had an internal consistency of α=0.897. The “knowledge of stroke symptoms” (r=0.705) and “knowledge to call 911” (r=0.942) subscales had the highest correlations with the SATI. The STAT had a correlation of 0.630 with the SATI. The SATI is an updated, psychometrically validated instrument for assessing stroke knowledge and treatment intent that includes measurement of thrombolytic treatment awareness.