A time series evaluation of the FAST National Stroke Awareness Campaign in England.

Darren Flynn,Nick Steen,Helen Rodgers,Christopher Price,Gary A Ford,Richard G Thomson,C Mary Schooling

doi:10.1371/journal.pone.0104289

Abstract

ObjectiveIn February 2009, the Department of Health in England launched the Face, Arm, Speech, and Time (FAST) mass media campaign, to raise public awareness of stroke symptoms and the need for an emergency response. We aimed to evaluate the impact of three consecutive phases of FAST using population-level measures of behaviour in England.MethodsInterrupted time series (May 2007 to February 2011) assessed the impact of the campaign on: access to a national stroke charity's information resources (Stroke Association [SA]); emergency hospital admissions with a primary diagnosis of stroke (Hospital Episode Statistics for England); and thrombolysis activity from centres in England contributing data to the Safe Implementation of Thrombolysis in Stroke UK database.ResultsBefore the campaign, emergency admissions (and patients admitted via accident and emergency [A&E]) and thrombolysis activity was increasing significantly over time, whereas emergency admissions via general practitioners (GPs) were decreasing significantly. SA webpage views, calls to their helpline and information materials dispatched increased significantly after phase one. Website hits/views, and information materials dispatched decreased after phase one; these outcomes increased significantly during phases two and three. After phase one there were significant increases in overall emergency admissions (505, 95% CI = 75 to 935) and patients admitted via A&E (451, 95% CI = 26 to 875). Significantly fewer monthly emergency admissions via GPs were reported after phase three (−19, 95% CI = −29 to −9). Thrombolysis activity per month significantly increased after phases one (3, 95% CI = 1 to 6), and three (3, 95% CI = 1 to 4).ConclusionsPhase one had a statistically significant impact on information seeking behaviour and emergency admissions, with additional impact that may be attributable to subsequent phases on information seeking behaviour, emergency admissions via GPs, and thrombolysis activity. Future campaigns should be a0ccompanied by evaluation of impact on clinical outcomes such as reduced stroke-related morbidity and mortality.

Highlights

Stroke is the third leading cause of death worldwide and a major cause of severe adult disability in developed countries [1,2]
With the exception of website visits, significant changes in level between February 2009 and March 2009 were identified for webpage views (82144, 95% confidence intervals (CIs) = 13845 to 150384), information materials dispatched (101081, 95% CI = 43530 to 158632), and calls to the Stroke Association (SA) helpline (339, 95% CI = 26 to 652)
Results adjusted for seasonality Adjusting for variation between calendar months in regression models (Tables S1 and S2) resulted in the change in levels between February 2009 and March 2009 for information materials dispatched by the SA and calls to their helpline no longer being statistically significant

Summary

Introduction

Stroke is the third leading cause of death worldwide and a major cause of severe adult disability in developed countries [1,2]. An expeditious response to stroke symptoms is critical [5]. Mass media interventions are promoted as an effective method of improving awareness of health issues and changing behaviour, including encouraging appropriate use of services [8]. A systematic review of 20 evaluations of mass media interventions for a range of conditions reported a positive effect on health services utilisation [8]. Such interventions targeted at stroke have a positive impact on knowledge, including awareness of the need for an emergency response, but with little impact on public behaviour [9]

Methods

Results

Discussion

Conclusion