Public Awareness Of Stroke Research Articles

The Influence of Providing Information and Educational Media in Efforts to Prevent Stroke

Stroke is the leading cause of physical and mental disability worldwide. In Indonesia, the incidence of stroke is alarmingly high, affecting approximately 10.9% of the population annually, with around 713,783 individuals experiencing stroke each year. Understanding how to prevent stroke is crucial. Clear and regular information, along with effective educational media, are essential for increasing public awareness of stroke. This study aims to determine the impact of social media and knowledge on stroke prevention. This type of study is a non-experimental quantitative study using a cross-sectional. This study is conducted in portions, with patients who are willing and able to talk effectively. Univariate, bivariate, and multivariate analyses were conducted using Pearson correlation tests and linear regression tests. The results show that among the 100 respondents, most were male, aged 41-60 years, and engaged in the best stroke prevention efforts. The Pearson correlation test showed significant correlations between information accuracy, frequency, and educational media for stroke prevention (Pearson p=0.89; p=0.62; p=0.75). The linear regression test revealed that the clarity of information, frequency of information, and educational media together increased stroke prevention efforts (p=0.037), with the clarity of information being the most significant factor. The conclusion is the study concludes that educational media and accurate information are crucial in preventing stroke. It is recommended that the Kasih Sayang Clinic conducts comprehensive stroke education and screening every six months to enhance prevention efforts.

Awareness of aphasia in Israel among Jewish and Arab societies

ABSTRACT Background Aphasia is relatively frequent after stroke (or other brain damage), estimated to occur in 21–38% of the patients. However, awareness of aphasia has been found to be disproportionally low in different countries. In recent years, there has been a transition in aphasia treatment from a predominantly medical approach to the “Life Participation Approach to Aphasia” (LPAA), acknowledging the communication needs of people with aphasia (PWA) and their reintegration into the community. To further advance these efforts, increased public awareness is crucial. Aim To explore awareness and basic knowledge of aphasia in the general population in Israel among Jewish and Arab populations. Method & Procedures Survey data was collected using the Public Awareness of Stroke and Aphasia questionnaire (Mavis, 2007), which was translated and adapted into Hebrew and Arabic. The questionnaire was distributed via social media (Facebook and WhatsApp). Four-hundred and thirty-eight questionnaires were analyzed. Two-hundred and fifty-five of the respondents were Israeli- Arabs and 183 were Israeli-Jews; 150 of the respondents reported having a professional health background. Results Only 44.5% of the respondents indicated familiarity with the term ”aphasia.” Familiarity declined to 26.7% when health profession respondents were excluded. In contrast, familiarity with other neurological diseases was higher. Basic knowledge of aphasia was also poor. Comparisons between responses of Israeli-Arab and Israeli-Jewish respondents revealed that Israeli-Jews were significantly more familiar with the term “aphasia” compared to Israeli-Arabs: 61.2% compared to 32.5%, respectively. Yet, among those who indicated familiarity with aphasia, Israeli-Arabs demonstrated a higher level of knowledge in two out of the three basic knowledge questions about aphasia. Conclusions Despite significant progress in recognizing the unique needs of PWA and integrating this paradigm shift into clinical practice, awareness of aphasia in Israel remains low, which might impede the integration and active participation of PWA in communication and social activities within the community. Therefore, besides improving clinical services for PWA, increasing public awareness of aphasia is crucial for the rehabilitation process.

Public knowledge of early stroke symptoms in the Vilnius region

Background and aim. Stroke remains one of the most common causes of death and disability in the world. The evident decline in disabling outcomes can be attributed to the increasing use of reperfusion therapies. Stroke recognition and urgent admission of patients to specialized stroke centres after the onset of first stroke symptoms are essential for treatment outcomes. This study aims to assess public stroke awareness and its change since 2019.Methods. An anonymous cross-sectional study involving 300 Vilnius residents was conducted in 2022, the results of which were compared with the data of 502 respondents in 2019. A closed-ended questionnaire was used for the study. Statistical analysis was performed using IBM SPSS software with p<0.05 significance level.Results. Stroke was identified as an acute cerebrovascular disorder by 83.3% of respondents in 2022 (82.7% in 2019). At least one correct warning sign of stroke was indicated by 98.7% of respondents (96.4% in 2019). The most commonly mentioned symptoms of stroke were one-sided face, arm or leg sensory disturbances, paralysis, or weakness (90.0%) and speech disorder (83.3%), with 82.1% and 81.5% respectively in 2019. Only 58% (45.4% in 2019) of respondents reported visual impairment as a stroke symptom. Women had better knowledge of stroke than men (p<0.05). The internet was the main source of information for 63.3% of respondents (64.9% in 2019).Conclusions. Since 2019, stroke awareness has improved in Vilnius. This proves that F.A.S.T. campaign has reached the public. Women have better knowledge of stroke than men. Visual impairment is the least known symptom of stroke. Therefore, the search for new information programmes, especially directed to the targeted audience, can be useful for better publicity.

Are digital social media campaigns the key to raise stroke awareness in low-and middle-income countries? A study of feasibility and cost-effectiveness in Nepal.

Stroke is a major global health problem and was the second leading cause of death worldwide in 2020. However, the lack of public stroke awareness especially in low- and middle-income countries (LMICs) such as Nepal severely hinders the effective provision of stroke care. Efficient and cost-effective strategies to raise stroke awareness in LMICs are still lacking. This study aims to (a) explore the feasibility of a social media-based stroke awareness campaign in Nepal using a cost-benefit analysis and (b) identify best practices for social media health education campaigns. We performed a stroke awareness campaign over a period of 6 months as part of a Stroke Project in Nepal on four social media platforms (Facebook, Instagram, Twitter, TikTok) with organic traffic and paid advertisements. Adapted material based on the World Stroke Day Campaign and specifically created videos for TikTok were used. Performance of the campaign was analyzed with established quantitative social media metrics (impressions, reach, engagement, costs). Campaign posts were displayed 7.5 million times to users in Nepal. 2.5 million individual social media users in Nepal were exposed to the campaign on average three times, which equals 8.6% of Nepal's total population. Of those, 250,000 users actively engaged with the posts. Paid advertisement on Facebook and Instagram proved to be more effective in terms of reach and cost than organic traffic. The total campaign cost was low with a "Cost to reach 1,000 users" of 0.24 EUR and a "Cost Per Click" of 0.01 EUR. Social media-based campaigns using paid advertisement provide a feasible and, compared to classical mass medias, a very cost-effective approach to inform large parts of the population about stroke awareness in LMICs. Future research needs to further analyze the impact of social media campaigns on stroke knowledge.

Abstract Number ‐ 31: No Mercy on Stroke Campaign: The Use of Pop Culture Icons to Raise Stroke Awareness

Introduction About 24–46% of acute ischemic strokes are due to large vessel occlusions1, however only a small fraction2,3 of thrombectomy eligible patients undergo emergent clot retrieval. Despite advances in thrombolytics and endovascular interventions, many patients are not candidates for emergent therapies due to delay in patient presentation, prehospital delay, triage delay and limited access to care. No Mercy on Stroke (NMOS) campaign aims to raise public stroke awareness by increasing social media footprint. Thereby enabling the general population with tools for earlier symptom detection, seeking rapid medical attention and fighting for legislature to improve prehospital networks. Methods Society of Vascular and Interventional Neurology (SVIN) launched NMOS campaign just prior to World Stroke Day (WSD) on October 25th, 2021 via Twitter. Pop culture icon and martialist Martin Kove launched the campaign as Sensei Kreese from the movie Cobra Kai in a video encouraging viewers to “strike fast and strike hard” when treating stroke. SVIN and Kove urged followers to spread the fight against stroke by sharing karate poses with hashtag #NoMercyOnStroke. Metrics such as social media reach, impact, location and others were extracted via Tweepsmap and Tweetbinder from October 25th, 2021 to August 20th, 2022. Results #NoMercyOnStroke was tweeted 716 times by 211 contributors4 across 19 countries and 77 cities5 for a potential reach of 374,200 people and potential impact of 2,051,908 people4. Tweet breakdown consisted of 126 original tweets and 590 retweets4. Engagements were primarily likes recorded at 2437, and followed by 97 replies and 55 quotes. Activity timeline was highest during week of WSD and accounted for majority exposure, however, there was another small peak in activity one month later. Top 3 countries involved were USA, Canada and India although USA accounted for 90.4% of all activity. Other countries include Mexico, Colombia, Spain, Egypt, Croatia, UK, Saudi Arabia, Kenya, Libya, Vietnam, Italy, Cuba, France, Peru, Chile and Venezuela5. Top associated hash tags were #worldstrokeday, #WSD and #alz0212465. Conclusions Use of pop culture icon as an advocate for stroke awareness greatly increased reach and impression of the NMOS campaign by touching nearly two million followers. Compared to raw data across three social media platforms for a similar campaign by Mission Thrombectomy called #BEFASTChallenge, #NoMercyOnStroke had exponentially more engagement with almost double the original posts and triple the retweets. Still, activity was concentrated around initial launch with minimal tail in the activity timeline. The overall impact of such campaigns on the end‐goal of decreasing the ratio of eligible thrombectomies to number of thrombectomies performed is yet to be uncovered. However, it is clear that larger campaigns involving celebrity influencers and community outreach are imperative to keeping the momentum of raising stroke awareness.

Public stroke awareness among Gharbia governorate inhabitants: a cross-sectional study

BackgroundStroke is the most common acquired neurological disease in the adult population worldwide with an incidence of 16 million new cases every year responsible for about 6.1 million deaths and 130.6 million disability-adjusted life-years (DALYs). The objectives of this work were to study the level of stroke awareness and the proper response for suspected stroke patients in urban and rural areas of Tanta City, Egypt. The study was conducted on 1869 Egyptian Citizens; 908 and 961 reside in urban and rural areas, respectively, who were submitted to a face-to-face interview using the stroke awareness questionnaire (Arabic version).ResultsRural participants showed a significant reduction in acute cerebrovascular stroke (CVS) awareness and knowledge including the most affected organ by CVS, what are the risk factors, what are the early stroke symptoms, is there specific treatment for acute ischemic stroke, and what is the proper reaction when confronted with a case of acute CVS?ConclusionUrban populations have better recognition of stroke risk factors, early stroke symptoms, and the proper response when confronted with a case of acute CVS when compared with rural people possibly due to better socioeconomic status and higher educational levels.

Knowledge and Response to Stroke Among Lebanese Adults: A Population-Based Survey.

ObjectivesTo date, research on public awareness of stroke warning symptoms, risk factors and practice in the general adult population in Lebanon is scarce. The aim of our study is to identify the level of stroke awareness in order to develop and implement preventive measures particularly in relationship to primary stroke prevention.MethodsIt is a cross-sectional study conducted among 410 adult participants from the five main governorates of Lebanon. Stroke knowledge and practice were assessed using two validated questionnaires namely the Stroke Knowledge Test (SKT) and the Stroke Action Test (STAT). Multivariable linear regression models were conducted to examine socio-demographic, social habits, and clinical factors independently associated with the SKT and the STAT scores.ResultsThe mean SKT score of the participants was 9.16. 48.5% showed a poor stroke-related knowledge level and 51.5% a good knowledge level. Living in Mount Lebanon and occasional smokers showed statistically significant lower mean SKT scores; whereas, university degree and suffering from diabetes mellitus were associated with higher mean SKT scores. The mean overall STAT score was 41.3%. For 36.8% of the stroke symptoms, respondents selected call 112. The mean STAT scores of participants who get their information from the internet was statistically significantly lower. However, no association was found between the SKT score and the STAT score.ConclusionKnowledge of stroke risk factors was low, as was awareness of the need to call 112 in response to stroke symptoms. Hence, it is essential to develop health education programs in order to decrease stroke morbidity and mortality.

Factors associated with hospital arrival time of acute stroke patients in rural India

Abstract Funding Acknowledgements Type of funding sources: None. Background Delays in the treatment of acute stroke leads to unfavorable prognosis. Shortening the delay time in the health care of these patients is essential in order to reduce the morbidity and mortality rates of this disease. Eligibility for acute stroke interventions depends on the time from symptom onset to hospital arrival. The socio-cultural profile in rural India is different from that in urban India. Lot of people in rural India prefer living in joint families, general level of education and awareness is low and they opt for alternative modalities of treatment for stoke. There is lack of adequate and fast transport facilities that worsen the scenario. Delay in arrival of acute stroke cases may be caused by organizational, educational, socioeconomic and demographic factors. Purpose This study was conducted to understand the factors associated with hospital arrival time of acute stroke patients in Rural India. Materials and Methods Hospital data of 27 acute stroke patients admitted to our clinic from January 2019 to December 2019 was retrospectively studied. Stroke was defined, according to the WHO definition, as 'rapidly developing clinical sign of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent cause other than of vascular origin'. Chi square test and Mann Whitney U tests were used to analyze the data. Results Only 8 (29.62%) patients arrived within 3 hours of stroke onset whereas 3 (11.11%) patients arrived after 12 hours. Mean and standard deviation of hospital arrival time in minutes for patients < 50 years was 125±116, for 51-60 years was 279±127, for 61-70 years was 379±191 and for >70 years was 1127±716.Younger patients reported significantly earlier than older ones (p <0.001). Males reported earlier than females (p: 0.032). Patients with stroke onset in the night time arrived significantly late compared to stroke onset in the day time (p:0.001). Prior ayurvedic treatment delayed hospital arrival (p <0.001). Conclusions A nationwide public awareness campaign is needed to improve the public awareness of stroke and importance of timely treatment when acute stroke symptoms are suspected. Lot of patients in rural India still delay emergency treatment of acute stroke due to preference to ayurvedic remedies which should be strongly discouraged. Gender and age bias need to be further studied and strategies to reduce the bias should be considered. This study shows that there is substantial room for reducing the time from symptom onset to hospital arrival in acute stroke. Strategies to improve stroke awareness and referral protocols together with the use of tele-medicine and mobile stroke unit should be considered to reduce the hospital arrival time.

Impact of a health campaign on Chinese public awareness of stroke: evidence from internet search data

IntroductionHealth campaigns have the potential to improve public awareness, but their impact can be difficult to assess. Internet search data provide information concerning online health information-seeking behaviour in the population...

Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments

Introduction: Stroke is one of the leading causes of death in Latin America, a region with countless gaps to be addressed to decrease its burden. In 2018, at the first Latin American Stroke Ministerial Meeting, stroke physician and healthcare manager representatives from 13 countries signed the Declaration of Gramado with the priorities to improve the region, with the commitment to implement all evidence-based strategies for stroke care. The second meeting in March 2020 reviewed the achievements in 2 years and discussed new objectives. This paper will review the 2-year advances and future plans of the Latin American alliance for stroke.Method: In March 2020, a survey based on the Declaration of Gramado items was sent to the neurologists participants of the Stroke Ministerial Meetings. The results were confirmed with representatives of the Ministries of Health and leaders from the countries at the second Latin American Stroke Ministerial Meeting.Results: In 2 years, public stroke awareness initiatives increased from 25 to 75% of countries. All countries have started programs to encourage physical activity, and there has been an increase in the number of countries that implement, at least partially, strategies to identify and treat hypertension, diabetes, and lifestyle risk factors. Programs to identify and treat dyslipidemia and atrial fibrillation still remained poor. The number of stroke centers increased from 322 to 448, all of them providing intravenous thrombolysis, with an increase in countries with stroke units. All countries have mechanical thrombectomy, but mostly restricted to a few private hospitals. Pre-hospital organization remains limited. The utilization of telemedicine has increased but is restricted to a few hospitals and is not widely available throughout the country. Patients have late, if any, access to rehabilitation after hospital discharge.Conclusion: The initiative to collaborate, exchange experiences, and unite societies and governments to improve stroke care in Latin America has yielded good results. Important advances have been made in the region in terms of increasing the number of acute stroke care services, implementing reperfusion treatments and creating programs for the detection and treatment of risk factors. We hope that this approach can reduce inequalities in stroke care in Latin America and serves as a model for other under-resourced environments.

General awareness of stroke in the Czech Republic.

The main goal of the study was to find out the general public's awareness of stroke, the relations between the awareness of stroke and socio-demographic factors, and awareness of stroke and experience of stroke. The combination of a non-standardized questionnaire on the stroke prevention and a standardized questionnaire on the identification of the general health literacy (HLSQ-16) was used. The sample was chosen using a quota choice. The sample structure corresponded with the composition of the Czech population with regard to regions, sex and age. These features were determined as representative. The sample consisted of 1,004 respondents. The general awareness of stroke is high in the Czech Republic. Most of the respondents (97.2%) stated that they had ever heard of stroke. This basic awareness is influenced by the sex and marital status of the respondents. Almost one half (42.2%) of the general public would welcome more information on stroke. Women showed significantly higher interest in the information than men. Significantly higher interest could be seen in elderly respondents while younger respondents said significantly more frequently that they were not interested in the information. Married respondents showed a significantly higher degree of awareness. Rural respondents expressed higher interest in the information. The interest in the information dropped with higher education. The interest was significantly influenced by the respondents' sex, place of residence, marital status, and education. Almost 1/4 (24.3%) of respondents mentioned stroke incidence in their families. Our study proved that this incidence significantly varied in dependence on the respondents' sex, age, marital status and education. Further questions were focused on the sources of information on stroke. The most important sources include internet, which was named by nearly one half (48.6%) of respondents, and it was found that women could use the sources of information more frequently than men. Women used all sources of information on stroke (internet, television, families, GPs) more than men. The Czech respondents' interest in stroke is significantly influenced by their sex, age, place of residence, marital status, and the respondents' education. The findings play a role in the focus on preventive activities in this area. It is necessary to implement the general public education not only in general practitioners' offices but also in mass media in order to improve the awareness of stroke.

Public Stroke Knowledge, Awareness, and Response to Acute Stroke in Isfahan Iran: What is Less or Misinterpreted in Developing Countries

BackgroundConsidering the high burden of stroke in developing countries, it is important for the community to have adequate information and awareness of this disease. In this study, the baseline knowledge of an Iranian population towards stroke has been evaluated. MethodThis study was conducted in a governmental hospital in Isfahan, Iran. The participants were selected from the companions of non-cardio-vascular hospitalized patients. A self-administered questionnaire was designed for gathering information ResultsA total of 630 questionnaires were analysed. Hypertension and stress were the most frequently identified risk factors (recognised by 83.7% and 75.8% respectively), while pregnancy, oral contraceptives, and anti-coagulants were the least (recognised by 3.5%, 14.2% and 15.8% respectively). Knowledge of other important risk factors such as cardiac diseases was also relatively low (39.4%). Sudden visual difficulties and irrelevant speech were the least identified warning signs of stroke (45.3% and 34.6% respectively), however, knowledge towards all other warning signs was moderately good (each identified by 60-70%). Importantly only 44.2% of respondents were aware that stroke treatment should be started within the first 3 hours. Participants tended to have moderately good insight of most stroke complications and rehabilitation (60-70%). Urban residence, high level of education and knowing someone with a history of stroke were significant predictors of a higher level of stroke awareness. ConclusionThe findings of this study indicate that there is a need to improve general knowledge of cardiac and hypercoagulable related risk factors. Furthermore, understanding of the importance of time critical stroke management and the ineffectiveness of traditional medicine needs to be raised in the general community.

Abstract P688: North Dakota Mission: Lifeline Stroke Public Awareness Survey Campaign Results Indicate Significant Improvements

The American Heart Association (AHA) Mission: Lifeline Stroke program is a 3-year initiative in North Dakota which aims to improve guideline-based care of stroke patients. Improving outcomes involves widespread awareness of stroke symptoms, early recognition, and timely access to emergency health care services. The purpose was to evaluate effectiveness of the public awareness campaign through a pre and post survey in 2018 and 2020 which assessed knowledge of the F.A.S.T acronym, actions and behaviors when stroke is suspected, and media preferences. The AHA commissioned Marketing & Advertising Business Unlimited, Inc., to conduct four hundred phone interviews in 2018 and 2020. Residents were randomly selected from a list of 24,000 landlines and 8,000 mobile phones. Data was weighted by gender, age, and region to conform to the latest statewide census. The survey had a 4.9% margin of error and a 95% confidence interval. Respondents reported having learned the signs and symptoms of stroke increased from 47.0% in 2018 to 68.3% in 2020. Awareness of symptoms changed as follows from 2018 to 2020: face related 30.0% to 43.1%; arm related 17.0% to 32.8%; speech related 39.0% to 41.0%. When asked what they would do first if stroke was suspected “Call 9-1-1- immediately” 64.0% to 70.7%, assess for F.A.S.T. symptoms then call 9-1-1 3% to 14.2%, drive themselves to the hospital 14% to 7.3% respectively in 2018 to 2020 . When asked if It would be better to transport someone experiencing stroke symptoms to a hospital by personal vehicle because driving could be faster than an ambulance in 2020 65% urban and 46% rural respondents disagreed. Media preferences were: 1) F.A.S.T. acronym over other longer options, 2) visuals with real humans 3) tagline “Care Starts When You Call”. In 2020 60% of respondents recalled advertisements about stroke signs and symptoms in the past 12 months. They recalled seeing messaging on: TV: 74.1%, Facebook: 20.1%, Radio: 19.1%, Billboard: 14.1%. Overall, the ND M:L public awareness communications were shown to have improved stroke symptom awareness and inclination to activate emergency services during a potential stroke. A preference for private vehicle presentation was noted in the rural cohort where transport time appears to be an influencing factor.

Abstract 13041: Stroke Mobile Apps: What About "FAST" and Other Risk Factors?

Do Stroke Apps Include FAST? Background: There are 325,000 mobile health apps, with 3.7 billion downloads annually. Stroke is a major health problem in America, affecting 795,000 annually. Yet, 1 in 3 Americans cannot name the stroke warning signs. Hypothesis: Mobile health apps that mention stroke fail to include FAST criteria and fail to provide information about stroke risk factors. Methods: “Stroke” was used as a search term for iOs and Droid apps. We evaluated free apps, and Stroke warning signs,(F=face droop, A= arm weakness, S=speech, T= call 911, FAST). We looked for risk factors such as Cholesterol (Chol), fasting blood sugar (FBS), smoking, hypertension (HTN), atrial fibrillation (AF), ethnicity, gender, and age. Results: We found 500 apps that mentioned stroke, of those, only 7 apps specifically list the FAST criteria. The number of apps mentioning key risk factors are listed: Chol: 3/8, FBS 2/8, Smoking 4/8, HTN 5/8, Vision Loss 6/8, Gender 4/8, Ethnicity:2/8, Afib 3/8. Only 1 app mentioned heart.org, and none mentioned Stroke.org or “cvriskcalculator.” Conclusion: Only a small proportion of mobile apps mentioning stroke list the FAST criteria, possibly delaying patients and families from taking appropriate rapid action. Apps also need to have more information about important risk factors for stroke. Improved visibility of these apps is needed to increase public awareness of Stroke.

Public Awareness of Stroke among Adult People in Eastern Region of Saudi Arabia, Community-Based Cross-Sectional Study

Public Awareness of Stroke among Adult People in Eastern Region of Saudi Arabia, Community-Based Cross-Sectional Study

FAST 112 HEROES: A kindergarten-based educational stroke intervention for the whole family

Background: Stroke is a worldwide leading cause of disability, and around 50 million people are affected by stroke annually. Public stroke educational and awareness programmes can make a great deal of difference. Young children are in key position to seek urgent medical care if grandparents suffer a stroke, as grandparents are often their secondary caretakers. Objective: The objective of the current study was to design an educational intervention targeting children and, in parallel, directly involve extended family members. Design: Participatory action research. Setting: School-based education stroke intervention in Thessaloniki, Northern Greece. Methods: Over the course of 5 weeks, this intervention sought to educate 66 preschool children and their families through a series of novel activities that revolved around 4 superheroes, the FAST mnemonic and a medical emergency number. One superhero and their unique superpower was introduced every week through a Powerpoint presentation, a short animation video and a wide range of in-class and take-home activities, such as ‘phantom speech’, role-playing, funny face mimicking games, and rhyming poems. Children were also encouraged to identify their own family superhero so as to transfer their learning to real life. Results: Follow-up individual and group assessment pointed to encouraging results. Results from odd-one-out-tasks revealed that children were able to recognise the stroke symptoms in question. However, they performed more poorly on more complex tasks involving recall. Conclusions: Preschool children acquired knowledge of stroke symptoms which appears more solid when recognition is assessed. Assessment tasks involving substantial recall of information do not necessarily reflect the ability to detect stroke symptoms.

Abstract TP392: Life in the F.A.S.T. Lane: Improving Stroke Patient and Family Education by Using F.A.S.T

Background and Purpose: Quality educational programs for stroke awareness promote early medical attention which lead to improved recovery and clinical outcomes. The implementation of an evidence-based education program using F.A.S.T. improved community awareness of both the signs and symptoms of stroke along with awareness of individual risk factors. The purpose of this quality enhancement initiative was to determine the efficacy of specific stroke education and the effects on the community for prompt medical treatment of suspected stroke when warning signs and symptoms are identified. Methods: A quality improvement pre-test/post-test design project was conducted to evaluate the implementation and impact of an evidenced-based patient/family centered education program regarding using F.A.S.T. and identifiable risk factors. Questions formulated using the Kirkpatrick Model. GetWell Rounds and Marabella application was used electronically at the beside to gather data. Outcomes were measured using a 10-point Likert scale in 311 patients and their caregivers at a busy level one trauma center over 5 months. As a result, creation of hospital wide education including videos, key discharge components and community outreach was newly implemented. Results: This evidenced-based initiative contributed to a significant increase in patients/families understanding of stroke signs and symptoms and recognition of individual risk factors that were modifiable. The highest level of improvement is comfort level explaining F.A.S.T. In addition, patient and caregiver survivors as well as non-stroke population participation in the community stroke programs have increased. Conclusions: Identifying stroke symptoms and acting rapidly can lower death and disability, but public awareness of stroke warning signs, symptoms and risk factors remains poor. Stroke educational programs are needed to improve community knowledge and behaviors to increase early treatment and potentially decreasing mortality. The community focused level is important to getting the message out and about stroke factors; therefore, developing cultural awareness is crucial.

Processes of Stroke Unit Care and Outcomes at Discharge in Vietnam: Findings from the Registry of Stroke Care Quality (RES-Q) in a Major Public Hospital

Background: An essential strategy to reduce mortality and disability after stroke is to ensure access to evidence-based care. In developed countries, it has been shown that if hospitals improve the quality of care, the impact of stroke is attenuated. However, in developing countries, data on the processes of care and associated patient outcomes are scarce. We examined the care processes and outcomes among patients with acute stroke from a stroke unit in a major public hospital in Vietnam whereby there are approximately 15,000 hospital admissions for stroke per year. Methods: We included first-ever strokes admitted to the 115 People’s Hospital (June 2017-March 2018). Data were collected in the Registry of Stroke Care Quality which is used in >50 countries. Baseline characteristics, stroke-related factors (e.g., type and severity), processes of care (e.g., thrombolysis), and outcomes at discharge were examined including mortality and functional outcome, assessed as the walking ability without assistance. Results: Data were available for 6601 patients with first-ever stroke (44% women, 80% ischemic stroke [IS], median age: 62 years, interquartile range [IQR]: 53-72) who received stroke unit care. The median time from stroke onset to hospital arrival was 15.7 hours (IQR: 5.6-37.5). At admission, the median National Institute of Health Stroke Scale score indicating stroke severity was 7 (IQR: 4-12). Among those with IS, 9% received intravenous thrombolysis. Over 90% of the participants received recommended process of care including dysphasia screening (99%), antihypertensive agents (92%), cholesterol-lowering medication (IS = 99%), and antithrombotic medication (IS = 98%). At discharge (median length of stay: 4 days, IQR: 3-6), 3% of all cases died and 46% were able to walk independently. Advanced age, stroke severity, and not receiving antihypertensive agent(s) were contributing factors to mortality and poorer functional outcome. Conclusion: There was a considerable delay in the time from stroke onset to hospital arrival. Evidence-based care at the stroke unit was consistently provided. It remains unclear whether other hospitals in Vietnam and other developing countries perform as well. Greater public awareness of stroke to reduce onset to arrival times and more stroke units are warranted to achieve the excellent outcomes in the major public hospital.

Delayed recognition of childhood arterial ischemic stroke.

Few population-based surveys of childhood arterial ischemic stroke (AIS) have been conducted in Asian countries. The aim of this study was to investigate the clinical features, time to diagnosis, and prognosis of childhood AIS in a population-based cohort in Japan. Children aged 29days-15years 11months old, residing in the Aichi Prefecture of Japan with radiologically confirmed AIS during 2010-2014, were identified retrospectively through questionnaires. We analyzed 40 children (23 boys, 17 girls; median age, 7years 3months), and collected time interval information of 26 patients. The time from clinical onset to first physician assessment and the time to AIS diagnosis were calculated. The most common presentation was paralysis or paresis in 27 patients (71%). No underlying disorders or possible trigger factors were identified in 14 patients (35%). The median time from symptom onset to first physician assessment was 2.9h. The median time from symptom onset to the confirmed AIS diagnosis was 27.0h. The diagnosis of AIS was made in the first 6h after onset of symptoms in 27% of patients for whom the time was available. Radiological diagnosis took longer than 24h in 54% of these patients. Long in-hospital delays exist in the diagnosis of AIS in children, likely due to lack of awareness of stroke by doctors. Further efforts to increase public and physician awareness of childhood stroke are needed to ensure early diagnosis and treatment.

Assessing Public Awareness and Knowledge of Stroke: A Case of Kumasi, Ghana

Background: The public awareness of stroke risk factors and warning signs is very imperative the in the quest to prevent diseases. In Ghana, public awareness of stroke as well as awareness of the effect of stroke is presently borne. The study attempts to examine the public awareness of stroke in Ghana. It also seeks to assess the risk factors associated with stroke.Methods: The study was a cross-sectional with 220 households in the Kumasi suburb. The study used structured questionnaires to ascertain data and logistics regression analyses to classify predicators on the recognition of stroke awareness, risk factors and stroke warning signs.Findings: It was revealed that, headache and numbness were the major stroke warning signs acknowledged and cited by respondent, and the commonest variable (factor) associated with stroke risk factors is ailing to exercise (44%). The findings of the logistic regression model on the predictors of stroke awareness showed that, stroke risk factors (OR=2.27, CI= CI = 1.52-3.71, p < 0.001) and religion (OR=11.66 CI=1.37-161.01), P<0.02) were linked with greater level of stroke risk factors.Conclusions: Though, stroke is seen as the common causes of mortality in Ghana, but our study showed appreciable number of respondents awareness of it risk factors, warnings signs and the fact that it is a topmost killer. This satisfactory was attributed to the sources of information and other imperative factors such as mounting stroke campaign programmes. Therefore, stroke campaign programmes and health education programmes should be rigorously mounted in universities, high schools, colleges so as to create the needed awareness of this killer disease, it risk factors and warning signs.