The impact of the UK ‘Act FAST’ stroke awareness campaign: content analysis of patients, witness and primary care clinicians’ perceptions

Stephan U Dombrowski,Falko F Sniehotta,Martin P Eccles,Richard G Thomson,Vera Araujo-Soares,Gary A Ford,Helen Rodgers,Madeleine J Murtagh,Joan E Mackintosh,Martin White

doi:10.1186/1471-2458-13-915

Abstract

BackgroundThe English mass media campaign ‘Act FAST’ aimed to raise stroke awareness and the need to call emergency services at the onset of suspected stroke. We examined the perceived impact and views of the campaign in target populations to identify potential ways to optimise mass-media interventions for stroke.MethodsAnalysis of semi-structured interviews conducted as part of two qualitative studies, which examined factors influencing patient/witness response to acute stroke symptoms (n = 19 stroke patients, n = 26 stroke witnesses) and perceptions about raising stroke awareness in primary care (n = 30 clinicians). Both studies included questions about the ‘Act FAST’ campaign. Interviews were content analysed to determine campaign awareness, perceived impact on decisions and response to stroke, and views of the campaign.ResultsMost participants were aware of the Act FAST campaign. Some patients and witnesses reported that the campaign impacted upon their stroke recognition and response, but the majority reported no impact. Clinicians often perceived campaign success in raising stroke awareness, but few thought it would change response behaviours. Some patients and witnesses, and most primary care clinicians expressed positive views towards the campaign. Some more critical participant comments included perceptions of dramatic, irrelevant, and potentially confusing content, such as a prominent ‘fire in the brain’ analogy.ConclusionsAct FAST has had some perceived impact on stroke recognition and response in some stroke patients and witnesses, but the majority reported no campaign impact. Primary care clinicians were positive about the campaign, and believed it had impacted on stroke awareness and recognition but doubted impact on response behaviour. Potential avenues for optimising and complementing mass media campaigns such as ‘Act FAST’ were identified.

Highlights

The English mass media campaign ‘Act FAST’ aimed to raise stroke awareness and the need to call emergency services at the onset of suspected stroke
Awareness raising activities were aimed at primary care clinicians including emails, newsletters, posters and leaflets
Primary care clinicians’ perceptions were examined as they represent the health care professionals closest to the community of individuals at risk of stroke and they play a crucial role in terms of raising awareness of stroke

Summary

Introduction

The English mass media campaign ‘Act FAST’ aimed to raise stroke awareness and the need to call emergency services at the onset of suspected stroke. Stroke awareness campaigns target the general population, including individuals who might experience stroke symptoms and those who might witness. In England the Department of Health has recently rolled-out the first national stroke awareness raising campaign ‘Act FAST’ [4] between February 2009 and March 2012.a The campaign included television, press and radio advertisements targeting the general population. Clear evidence of the effects of the campaign upon response behaviours is currently lacking [6] These findings have recently been replicated in Ireland which used the ‘Act FAST’ campaign with minor modifications (e.g. Irish voiceover) [7] and are in line with previous evaluations of stroke mass media campaigns reporting variable and modest effects on response behaviour and speed [1]

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Conclusion