Abstract

Background: Black Americans comprise 14% of Michigan’s population, but 30% of the COVID-19 cases and 40% of deaths. The accumulating national quantitative data on decreased presentation and increased pre-hospital delay during the pandemic confirmed our Flint, MI community partners’ impression of a decline in stroke presentations. Thus, we set out to understand the community’s perception of seeking acute stroke care during the pandemic which will inform the development and dissemination of public health messaging in a predominantly Black American community. Method: To honor social distancing orders, we conducted semi-structured interviews based on the Theory of Planned Behavior via HIPAA-approved teleconferencing with community members. Due to the clinical and public health implications of the pandemic, we employed a rapid assessment approach to streamline qualitative data analysis. Results were used to inform the creation of a music video. Lyrics were written by the academic team, set to a soundtrack and sung by a community partner. The music video theme was conceptualized by the academic team and performed by both academic and community partners. Results: We reached thematic saturation after completing 15 semi-structured interviews with Flint, MI community members. Mean duration of interviews was 40 minutes. Eighty percent of participants were Black; median age was 50; 74% were women and 47% reported some college or above. There was an unfavorable attitude towards seeking emergent stroke care via ambulance and at the hospital, due to concerns for viral transmission at the hospital, hospital capacity and ability to triage, and quality of care. Community and academic partners co-created a music video with verses addressing the community-identified barriers: “ stroke is an emergency all the time, even with COVID-19 / get to the hospital as soon as symptoms start, it’s so important to do your part, be Stroke Ready” (https://youtu.be/lKefAiUM2W0) The video reached over 1,200 users on our community-academic partner Stroke Ready Facebook page. Conclusion: We found that community members’ attitudes and perceived behavioral control to seek emergent stroke care were impacted during the COVID-19 pandemic. We addressed these barriers in an academic-community partner created music video. Academic and community partnerships facilitated a timely, innovative response to seeking acute stroke care in the setting of the COVID-19 pandemic.

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