A community education program on atrial fibrillation: Implications of pulse self-examination on awareness and behavior

Abstract

We postulated that community groups with older demographics could be taught to find and characterize their pulse rhythm for the presence of an irregular pulse (IP), which may indicate atrial fibrillation, a major risk factor for stroke. We conducted 281 community group education sessions involving 6203 attendees. Awareness objectives were to demonstrate that: (1) group education was effective in establishing awareness that an IP may indicate atrial fibrillation; and (2) this message was retained at follow-up. Behavioral objectives were to: (1) assess ability of participants to find and characterize their pulse rhythm; (2) regularly monitor pulse rhythm; and (3) act with medical appropriateness upon detecting an IP. Of 6203 attendees, 4322 were older than 50 years and consented to participate. Of these consenting participants, 73.2% found their radial pulse and 91% characterized the rhythm (regular, 72.1%; irregular, 11%; undetermined, 7.9%). Telephone follow-ups on 1839 participants were performed at 30 to 60 days to assess durability of message and action taken. At follow-up, 89.1% remembered that an IP is potentially a risk factor for stroke, and 70.3% had taken their pulse since the program. Of those who discovered a new IP, 38% sought medical assessment. Community education programs focusing on pulse self-examination are effective in improving awareness that an IP may be a surrogate indicator of stroke risk. Such programs may lead to improved awareness of atrial fibrillation, subsequent behavioral changes, and stroke prevention.