Stroke Knowledge Scores Research Articles

Evaluating the influence of a 3-min online video on the community knowledge of stroke in four Arab countries.

Studies from developed and developing countries showed that the knowledge levels of stroke need improvement. Educational campaigns varied and were of limited influence predominantly because of their short duration and the need for financial support. The study aims to test the impact of a 3-min online video on the knowledge of stroke and factors influencing the knowledge score in four Arab countries. A cross-sectional web-based pre-post study was conducted in Egypt, Jordan, Lebanon, and the United Arab Emirates. The data were collected using the snowball technique. Participants were adults aged 18 years and above. The questionnaire sequence was conducting a pretest, followed by the educational video explaining stroke occurrence, types, risks, warning signs, preventive measures, and treatment, and finally, a posttest to evaluate the differences in knowledge from baseline. Statistical analysis included paired t-tests comparing pre-post-education stroke knowledge scores, while repeated measures ANOVA, adjusting for covariates, assessed mean changes. The total number of participants was 2,721, mainly younger than 55 years. The majority had a university degree and were not healthcare professionals. A significant improvement was noted in the total knowledge score in all countries from a mean average (Mpretest = 21.11; Mposttest = 23.70) with p < 0.001. Identification of the stroke risks (Mpretest = 7.40; Mposttest = 8.75) and warning signs (Mpretest = 4.19; Mposttest = 4.94), understanding the preventive measures (Mpretest = 5.27; Mposttest = 5.39) and the importance of acting fast (Mpretest = 0.82; Mposttest = 0.85) improved from baseline with (p < 0.001) for all score components. The educational tool successfully enhanced public understanding of stroke risks, the identification of stroke signs, and the critical need for emergency action. The advantages of this video include its short length, free online access, use of evidence-based content in lay language, and reflective images. The ultimate goal remains the long-term improvement of sustainability by mandating full-scale trials.

A community-based participatory approach to increase public knowledge of stroke among ethnic minorities in the northern mountains of Thailand

This study examines a stroke education program about knowledge of stroke among community partners that aims to increase the public knowledge of stroke in ethnic minorities. A one-group pre-test/post-test experimental design based on a community-based participatory approach was used in four steps following established community collaboration, planned intervention, community partner recruitment and training, implementation, and evaluation. The study was conducted between September 1, 2019 and February 28, 2020 in Chiang Rai province of Thailand. Purposive sampling was used to select 50 community partners, and cluster random sampling was used to select 419 participants from ethnic minorities. The 50 community partners already trained by researchers in the stroke education program proffered their knowledge of stroke to the ethnic minorities over a period of 1 month. A stroke knowledge questionnaire was used to test stroke knowledge among ethnic minorities before intervention (baseline) and 1 month later (post-intervention). At post-intervention, 60.6% of ethnic minorities could correctly recall more than 3 warning signs of stroke, while 51.3% correctly identified more than 3 risk factors for stroke. The score differed among 159 participants who could not speak Thai pre-intervention (mean=0.03, SD=0.39) and post-intervention (mean=7.52, SD=1.33). There were significant differences in pre-intervention and post-intervention overall stroke knowledge scores of 4 major ethnic groups (mean 0.57, SD=1.63 versus mean 7.62, SD=1.39; t=−67.38, p&lt;.001). The stroke educational program based on community-based participatory research can increase public stroke knowledge and help to overcome cultural and language barriers in ethnic minorities.

Knowledge of Stroke and Planned Response among Patients Living with Diabetes Mellitus and Hypertension in a Primary Care Unit

Background: Stroke is an important worldwide public health problem. Lack of knowledge in prevention methods, warning symptoms and planned response of acute stroke are associated with a longer prehospital time, which affect the morbidity and mortality of patients.Objective: The primary objective was to assess knowledge of stroke prevention methods and warning symptoms among patients living with diabetes and/or hypertension. The secondary objectives were to define planned responses when suspecting acute stroke, and identify associated factors with stroke knowledge scores and planned responses.Materials and Methods: A cross-sectional study was conducted in patients living with diabetes and/or hypertension, who had continuous follow up at the primary care unit of Songklanagarind Hospital. The outcomes of this study were assessed by a questionnaire, which was developed from a literature review.Results: This study included 312 participants. Median age was 64.0 years (Q1, Q3 = 58.0, 71.0), and 59.6% were female. Median score of knowledge of stroke prevention methods were 9, from 12 points (Q1, Q3 = 8, 10), and warning symptoms were 7, from 10 points (Q1, Q3 = 6, 8); with 80.1% of them knowing all 3 warning symptoms, according to the acronym FAST. Only 22.8% of participants would go to the hospital immediately, by calling an ambulance when they experienced symptoms of a suspected acute stroke. Participants who had income had statistically significant higher knowledge of stroke prevention methods; while participants under 60 years of age, who had a longer duration of diagnosed diabetes mellitus were associated with appropriate planned responses when suspecting acute stroke.Conclusion: Patients living with diabetes mellitus and hypertension, who are at a high risk for developing cardiovascular diseases, still do not have enough knowledge about acute stroke and had little concern about developing a stroke; especially the elderly and those with a short duration of having been diagnosed with diabetes mellitus.

Impact of a Pre-Discharge Education Session on Stroke Knowledge: a Randomized Trial

Background and purposesStroke knowledge, awareness of risk factors and stroke warning symptoms is very poor among stroke survivors. We investigated whether a pre-discharge education intervention in the stroke unit could improve stroke knowledge in patients with TIA or minor stroke. MethodsWe performed a prospective single-center, randomized controlled trial (2013-2016) in patients with TIA or minor stroke. The intervention consisted in an interactive group session focused on stroke education, within the stroke unit before hospital discharge. Primary outcome was the 3-month change in stroke knowledge score (SKS) from randomization. Secondary outcomes were the 12-month change in SKS, the number of risk factors and warning signs named, control of risk factors and self-reported adherence. ResultsA total of 199 patients (mean [SD] age, 63.5 [12.4] years; 67 [33.7%] women) were randomized (99 in stroke education session). Intervention was associated with a greater improvement in SKS than in the control group (baseline-adjusted mean between-group difference, 1.6 point [95%CI, 1.4 to 1.9]; p=0.001). This difference was significantly maintained at 12 months. The number of risk factors and warning signs named were significantly increased in the intervention group at 3 months. Control of risk factors and self-reported adherence did not differ significantly between the two groups. ConclusionsAn interactive education session in the stroke unit significantly improved stroke knowledge at 3 months and 12 months in patients with TIA or minor stroke.

Knowledge of heart attack and stroke symptoms among US Native American Adults: a cross-sectional population-based study analyzing a multi-year BRFSS database

BackgroundHeart disease and stroke are among the leading causes of death in Native Americans. Knowledge of heart attack and stroke symptomology are essential for prompt identification of symptoms and for appropriate action in seeking care. Knowledge of heart attack and stroke symptoms among US Native American adults was this study’s focus.MethodsMultivariate techniques were used to analyze national surveillance data. Native American adults comprised the study population. Low heart attack and stroke knowledge score was the dependent variable.ResultsLogistic regression analysis yielded that Native American adults with low heart attack and stroke composite knowledge scores were more likely to be: older, less educated, poorer, uninsured, a rural resident, male, without a primary health care provider, and lacking a recent medical checkup.ConclusionsThe identified characteristics of Native American adults with heart attack and stroke knowledge deficits or disparities should guide educational initiatives by health care providers focusing on improving such knowledge.

Abstract WP240: Community Engagement for Early Recognition and Immediate Action in Stroke (CEERIAS): Exploring Stroke Knowledge, Self-Efficacy, and Trust in the Healthcare System in Chicago

Introduction: In a segregated city like Chicago with distinct neighborhood characteristics, a discrepancy between neighborhoods in stroke knowledge, self-efficacy, and trust in the medical system could impact stroke outcomes. Methods: As part of a study which implemented a culturally-tailored stroke preparedness intervention targeting South (S) Side Chicago communities, individuals attending community health events were recruited in S neighborhoods and North (N) Side neighborhoods pre- and one-year post-intervention to assess stroke knowledge, self-efficacy, and trust. Independent stand-alone pre- and post-sample cohorts were purposefully recruited to match demographics. Survey outcomes included knowledge (assessed via Stroke Action Test, STAT), self-efficacy (Likert scale), trust (Health Care Trust Survey), and stress (Likert). Zip codes divided subjects into S/N neighborhoods. Two-sample t-tests compared cohorts, and interactions between race/ethnicity-time and neighborhood-time were tested, with multivariable linear regression when statistically (p&lt;0.05) significant. Results: We recruited 364 subjects pre-intervention (S=199, N=165) and 363 subjects post-intervention (S=198, N=165) who were well-matched in race/ethnicity, sex, and education, though the post-group was slightly younger (p=0.04). Unadjusted analysis revealed increases post-intervention in stroke knowledge (p=0.07), self-efficacy (p&lt;0.0001), trust (p&lt;0.0001), and stress scores (p&lt;0.0001). After adjusting for race/ethnicity, gender, and age, the N post-group had greater gains in knowledge (N: 4.0, p=0.02 vs. S: 0.7, p=0.69), self-efficacy (N: 2.3, p&lt;0.0001 vs. S: 0.7, p&lt;0.0001), trust (N: 0.8, p&lt;0.0001 vs. S: -0.1, p=0.20) and stress (N: -0.3, p&lt;0.0001 vs. S: -0.1, p=0.04). Conclusions: The observed gains in stroke knowledge, self-efficacy, trust, and stress, greater in the North Side of Chicago, could signal overall improved public health messaging around stroke recognition and treatment, but could also point to socioeconomic factors that may have disproportionately benefited North Side residents. Further focused research to understand neighborhood factors which influence stroke awareness and action is necessary.

Implementation of an in-hospital stroke simulation protocol

PurposeA major component of hospital stroke care involves prompt identification of stroke in admitted patients. Delays in recognizing stroke symptoms and initiating treatment for in-hospital stroke can adversely impact patient outcomes. This quality improvement intervention used simulation together with a traditional lecture to instruct nurses at a university hospital about a new stroke protocol being implemented to increase rapid recognition of stroke and meet Joint Commission National Hospital Inpatient Quality Measures. The paper aims to discuss these issues.Design/methodology/approachIn total, 86 registered nurses from the neurology and cardiology units attended a lecture and participated in a simulation scenario with a standardized patient exhibiting stroke symptoms. Participants completed a ten-item pre-test to measure their knowledge of stroke care prior to the lecture; they repeated the test pre-simulation and once again post-simulation to evaluate changes in knowledge.FindingsOverall mean stroke knowledge scores increased significantly from pre-lecture to pre-simulation, and from pre-simulation to post-simulation. Simulation plus lecture was more effective than lecture alone in increasing knowledge about hospital stroke protocol despite assigned unit (cardiology or neurology), years of experience, or previous exposure to simulation.Research limitations/implicationsAll eligible nurses who agreed to participate received training, making it impossible to compare improvements in knowledge to those who did not receive the training.Originality/valueA diverse array of nursing professionals and their patients may benefit from simulation training. This quality improvement intervention provides a feasible model for establishing new care protocols in a hospital setting.

Spreading Awareness of Stroke through School-Based Education: A Pooled Analysis of Three Community-Based Studies

Advancing school-based education is a promising means to spread knowledge pertaining to stroke. The aim of the current study was to clarify whether stroke lessons provided by schoolteachers could deliver stroke knowledge to children (aged 9-11 years) and their parents, at a similar level to when taught by medical staff. Schoolteachers conducted lessons on stroke for school children using the educational materials we prepared (i.e., the teacher group; 1051 children and 719 parents). This was compared with our previous data from Akashi city and Tochigi prefecture, in which the stroke lessons were conducted by medical staff (i.e., the medical group; 1031 children and 756 parents). Three campaigns were conducted between September 2014 and May 2016. Each child was given education materials to take home to discuss stroke with their parents. The children and their parents answered questionnaires on stroke knowledge, at baseline, immediately after the lesson, and at 3 months after the lesson. Compared with the time point before the lesson, both children and parents instructed by the teacher group showed significant increases in the scores about stroke symptoms and risk factors, immediately and at 3 months after the lesson (P < .001). The combined analysis for the group instructed by medical personnel showed no significant differences in the stroke knowledge scores between the 2 groups at 3 months. Teacher-led lessons, using our educational material, adequately delivered knowledge of stroke to children and parents, in a manner that was similar to when medical staff delivered this information.

Abstract 203: Community Based Outpatient Stroke Rehabilitation Program Achieves Excellent Outcomes Including Return to Work, Driving, Improved Blood Pressure Control, and Other Rehabilitation Outcomes

Background: Return to Driving and Employment are goals for many stroke survivors. These person-centered goals are often the motivators for participation in outpatient rehabilitation. However, standardized measure sets and patient assessments are not in place or required for outpatient rehabilitation programs. As such, few outpatient rehabilitation programs measure and report patient centered outcomes like return to work or employment in addition to functional status and disease management measures. Methods: Prospective observational study of recovery of stroke patients treated between 12/2011-1/2015 in an interdisciplinary outpatient rehabilitation program that addresses health literacy, risk factors, physical, psychosocial, cognitive, communicative and vocational issues. Results: Among 96 consecutive patients (69 ischemic, 27 hemorrhages), with admit NIHSS scores 0-16, there were 59 men, 37 women, with an age range of 18-90 years. At baseline(admission to the outpatient program), 36.5% were aphasic(communication impairment), 88% had impairments and needed assistance with activities of daily living (55% and 33% with modified Rankin Scale [mRS] Scores of 3 and 4, respectively), compared with mild impairments (12%mRS 1-2). Of 46 patients working pre-stroke, 48% had returned to work and an additional 13% were work capable at discharge. Of 86 patients driving pre-stroke, 38% returned to driving at completion of the program and 27% began using public transportation. Stroke Impact Scale (SIS) stroke recovery Domain scores increased an average of 38%, SIS ADL scores 33%, SIS mood scores 17%. Cardiovascular and medication education sessions with the Nurse Practitioner(NP) were based on AHA guidelines that included Life’s Simple 7’s curriculum. Stroke Knowledge scores improved an average of 14% and stroke risk factor knowledge improved an average of 19% across program participants. Program treatment also emphasized blood pressure control and exercise, with all but 1 patient receiving an average of 23 physical therapy visits over the duration of program involvement. Compared with baseline, 6 minute walk and Berg Balance scores improved an average of 79% and 33%, respectively. Blood pressures(BPs) measured during the 1st 75% of PT visits were compared to BPs during the last 25%. 56% of patients had fewer moderate(140-159/91-99) to severe(&gt;160/100) BPs and more normal(&lt;120/80) to mild (121-139/81-90) range BPs. 15% had no change in mild-normal range and 29% had some worsening of BPs over the course of PT treatment. Conclusions: Participants in our interdisciplinary community-based rehabilitation program demonstrated improvements in stroke knowledge, physical function, blood pressure control, and mood, while also returning to work, driving, and participation in the community. Comparative research and multi-site studies are needed.

Abstract WP175: Health Literacy, Knowledge and Competency: Lessons from the SWIFT Community Study

INTRODUCTION: Racial disparities in stroke preparedness and prevention persist. Emerging research emphasizes the importance of stroke knowledge; however significant gaps remain. The aim of this work was to explore factors related to stroke knowledge/preparedness attainment in a stroke-free community setting. Methods: The Stroke Warning Information and Faster Treatment Community (SWIFT) study was a randomized stroke preparedness educational intervention, which prospectively enrolled stroke-free community members from 30 Northern Manhattan community-based organizations. This culturally tailored health literate intervention utilized visuals, and interactive sessions to overcome educational and language barriers. Baseline demographics and a validated stroke knowledge score (SKS) were assessed by interviewer administered questionnaires at each of the community sites. Health literacy was assessed using the Short Test of Functional Health Literacy in Adults. At the end of the intervention, we assessed competency of stroke knowledge and preparedness using an open-ended teach back methodology. Results: The cohort included 423 stroke free community residents; mean age 64.1 years; 77% female; 30% white, 27% black, 40% Hispanic. Mean baseline stroke knowledge score was 72.4%. In a multivariate model adjusted for age, SKS was significantly associated with education (p &lt;.0001) gender (p=.0046) and Latino race (p &lt;.0001) with Latino males having less than high school education scoring 5 points less than white females with HS or more. While 46% demonstrated competency on the multiple choice section, only 26% demonstrated competency on open ended behavioral intent questions. Health literacy level was significantly correlated (r=.324, p=.0001) with total stroke knowledge score, but was not correlated with post-intervention competency assessment (r=.116, p=.116). Of the 76% that had a competency score, 77% demonstrated full competency post intervention. Discussion: Mismatch between multiple choice knowledge score and competency indicate that not all evaluation methods correspond to true learning. Appropriate intervention can overcome disparities in health literacy to improve stroke education for all.

Randomised controlled trial of an education and support package for stroke patients and their carers

ObjectiveTailoring stroke information and providing reinforcement opportunities are two strategies proposed to enhance the effectiveness of education. This study aimed to evaluate the effects of an education package which utilised...

CB3-01: Comparison of Ethnicity and Race Categorization in Electronic Medical Records and by Self-report

Anna Bergdall1, Stephen Asche1, Nicole Schneider1, Tessa Kerby1, Karen Margolis1, JoAnn Sperl-Hillen1, Jaime Sekenski1, Rachel Pritchard1, Michael Maciosek1 and Patrick O’Connor1 1HealthPartners

Knowledge of heart attack and stroke symptomology: a cross-sectional comparison of rural and non-rural US adults

BackgroundUnderstanding the signs and symptoms of heart attacks and strokes are important not only in saving lives, but also in preserving quality of life. Findings from recent research have yielded that the prevalence of cardiovascular disease risk factors are higher in rural populations, suggesting that adults living in rural locales may be at higher risk for heart attack and/or stroke. Knowledge of heart attack and stroke symptomology as well as calling 911 for a suspected heart attack or stroke are essential first steps in seeking care. This study sought to examine the knowledge of heart attack and stroke symptoms among rural adults in comparison to non-rural adults living in the U.S.MethodsUsing multivariate techniques, a cross-sectional analysis of an amalgamated multi-year Behavioral Risk Factor Surveillance Survey (BRFSS) database was performed. The dependent variable for this analysis was low heart attack and stroke knowledge score. The covariates for the analysis were: age, sex, race/ethnicity, annual household income, attained education, health insurance status, having a health care provider (HCP), timing of last routine medical check-up, medical care deferment because of cost, self-defined health status and geographic locale.ResultsThe weighted n for this study overall was 103,262,115 U.S. adults > =18 years of age. Approximately 22.0% of these respondents were U.S. adults living in rural locales. Logistic regression analysis revealed that those U.S. adults who had low composite heart attack and stroke knowledge scores were more likely to be rural (OR = 1.218 95%CI 1.216-1.219) rather than non-rural residents. Furthermore, those with low scores were more likely to be: male (OR = 1.353 95%CI 1.352-1.354), >65 years of age (OR = 1.369 95%CI 1.368-1.371), African American (OR = 1.892 95%CI 1.889-1.894), not educated beyond high school (OR = 1.400 955CI 1.399-1.402), uninsured (OR = 1.308 95%CI 1.3-6-1.310), without a HCP (OR = 1.216 95%CI 1.215-1.218), and living in a household with an annual income of < $50,000 (OR = 1.429 95%CI 1.428-1.431).ConclusionsAnalysis identified clear disparities between the knowledge levels U.S. adults have regarding heart attack and stroke symptoms. These disparities should guide educational endeavors focusing on improving knowledge of heart attack and stroke symptoms.

The Relationship between Knowledge and Risk for Heart Attack and Stroke

Stroke and myocardial infarction (MI) represent 2 of the leading causes of death in the United States. The early recognition of risk factors and event symptoms allows for the mitigation of disability or death. We sought to compare subject knowledge of stroke and MI, assess subject risk for cardiovascular disease, and determine if an association exists between knowledge and risk. In this cross-sectional survey, adult, non-health care professionals were presented with a written knowledge test and risk assessment tool. Subjects were classified into 3 categories of cardiovascular risk. Associations were then calculated between knowledge, risk, and population demographics. Of 500 subjects approached, 364 were enrolled. The subjects were mostly white, middle-aged, and high school educated. Gender and income were evenly distributed. Forty-eight (14%) subjects were identified as ideal risk, 130 (38%) as low risk, and 168 (49%) as moderate/high risk. MI and stroke knowledge scores decreased as cardiovascular risk increased (85%, 79%, and 73% for ideal, low, and moderate/high risk groups, respectively; P < .001). In addition, regardless of risk category, stroke knowledge scores were always lower than heart attack knowledge scores. Knowledge about stroke and MI was modest, with knowledge of MI exceeding that of stroke at every level of risk. Subjects with higher risk were less knowledgeable about the stroke signs, symptoms, and risk factors than those of MI.

Stroke Knowledge in an Irish Semi-Rural Community-Dwelling Cohort and Impact of a Brief Education Session

Poor knowledge of stroke risk factors and failure to recognize and act on acute symptoms hinders efforts to prevent stroke and improve clinical outcomes. Levels of stroke knowledge are poorly established within Ireland. This study was conducted to establish levels of knowledge among men and women aged >40 years in an Irish community, and also to determine the impact of a single education session on stroke knowledge. Subjects from 2 separate geographical locations were allocated to an intervention group (n = 200), who received stroke information over a 90-minute session, or a control group (n = 200). Both groups completed a stroke knowledge questionnaire at baseline and at 4 weeks after the educational session. Overall, the initial response rate was 70% (280/400); 52% of the respondents knew that the brain is affected by stroke, 58% could list 2 or more risk factors but only 27% could list 2 or more warning signs, 50% would call 999 (emergency number in Ireland) in response to stroke, 17% had heard of thrombolytic therapy, but only 1% knew the time frame for receiving thrombolytics. The response rate to the resurvey following the educational session was 57%, with 47 of 117 subjects in the intervention group (40%) attending the session. Stroke knowledge scores improved by 50% in the intervention group (P < .001). Overall, the knowledge of stroke risk factors, warning signs, and thrombolytic therapy was poor in this Irish community-dwelling cohort. Our study demonstrates that a single educational session can improve short-term knowledge of stroke symptoms and thrombolytic therapy.

Disparities in Stroke Symptomology Knowledge among US Midlife Women: An Analysis of Population Survey Data

A higher prevalence of stroke appears to exist among women aged 45 to 54 years compared with same-aged men. In addition, compared with their male counterparts, women have a threefold risk of delay in hospital arrival time. Inadequate knowledge of stroke symptomology may account for this disparity in hospital arrival time. We assessed current knowledge of stroke symptoms among US women in midlife and examined the relationship between symptom knowledge and race, income, education, deferring medical care, having a primary care provider, and health insurance status. This was a cross-sectional study analyzing 2003-2005 Behavioral Risk Factor Surveillance Survey data. From the 7 stroke symptom knowledge questions asked on the survey, a Stroke Knowledge Score was computed for each respondent. Multivariate data analysis techniques were used. Multivariate analysis revealed that US women aged 45 to 54 years with low stroke knowledge scores were: more likely to be Hispanic (OR = 4.44, CI = 4.37-4.51) or African-American (OR = 2.55, CI = 2.52-2.58); have less than a high school education (OR = 2.67, CI = 2.63-2.71); have an annual household income <$35,000 (OR = 2.00, CI = 1.98-2.02); have a primary care provider (OR = 1.78, CI = 1.75-1.81); have deferred medical care because of cost (OR = 1.35, CI = 1.33,1.36); and are less likely to have health insurance (OR = 0.70, CI = 0.67- 0.71). Disparities in stroke symptom knowledge exist along racial/ethnic and socioeconomic lines. Nevertheless, mid-life women have high levels of knowledge about the symptoms of stroke, hence strategies aimed at encouraging women to act promptly when experiencing symptoms could yield more benefit in reducing delays in stroke treatment than educational programs.

Disparities in Knowledge of Heart Attack and Stroke Symptoms among Adult Men: An Analysis of Behavioral Risk Factor Surveillance Survey Data

Context:The staggering burden of myocardial infarction and stroke in men and for men of African-American descent in particular provided the impetus for this study. Morbidity and mortality from these vascular disorders can be reduced by early treatment, which requires correct prehospital identification of symptoms. Objective:The purpose of this study was to assess current knowledge of myocardial infarction and stroke symptoms and to examine if there were disparities in knowledge of these among U.S. males. Design:This is a cross-sectional study analyzing public use 2003-2005 Behavioral Risk Factor Surveillance Survey data. Univariate, bivariate and multivariate techniques were used. Setting:Random-digit-dial telephone survey focused on health risk factors and behaviors. Data collection was done under the direction of the Centers for Disease Control and Prevention.Patients or Other Participants:Data collections targeted noninstitutionalized U.S. adults 18-90 years of age. This study focused on the adult male population. Main Outcome Measures:From the 13 heart attack and stroke symptom knowledge questions asked on the survey, a heart attack and stroke knowledge score was computed for each respondent.Results: Multivariate analysis revealed that both Caucasian and African-American men earning low scores on the knowledge questions were more likely to: have less than a high-school education, have deferred medical care in the past 12 months because of cost and not have health insurance in the past 12 months. African-American men were also more likely to live in households with annual incomes <$35,000 and were more likely to not have a primary care provider; this was not true for Caucasian men. Conclusions:There is a disparity in myocardial infarction and stroke symptom knowledge along racial and socioeconomic lines. African-American males, poorer individuals and those with lower levels of education had significantly lower scores. Since these subgroups are also among those at higher risk for stroke and myocardial infarction, targeting measures to enhance knowledge in these groups might yield more benefit than programs aimed at the general male populace.

Disparities in Adult African American Women's Knowledge of Heart Attack and Stroke Symptomatology: An Analysis of 2003–2005 Behavioral Risk Factor Surveillance Survey Data

Heart disease and stroke are the first and third leading causes of death of American women, respectively. African American women experience a disproportionate burden of these diseases compared with Caucasian women and are also more likely to delay seeking treatment for acute symptoms. As knowledge is a first step in seeking care, this study examined the knowledge of heart attack and stroke symptoms among African American women. This was a cross-sectional study analyzing 2003-2005 Behavioral Risk Factor Surveillance Survey (BRFSS) data. A composite heart attack and stroke knowledge score was computed for each respondent from the 13 heart attack and stroke symptom knowledge questions. Multivariate logistic regression was performed using low scores on the heart attack and stroke knowledge questions as the dependent variable. Twenty percent of the respondents were low scorers, and 23.8% were high scorers. Logistic regression analysis showed that adult African American women who earned low scores on the composite heart attack and stroke knowledge questions (range 0-8 points) were more likely to be aged 18-34 (OR = 1.36, CI 1.35, 1.37), be uninsured (OR = 1.32, CI 1.31, 1.33), have an annual household income <$35,000 (OR = 1.46, CI 1.45, 1.47), and have a primary healthcare provider (OR = 1.22, CI 1.20, 1.23). The findings indicated that knowledge of heart attack and stroke symptoms varied significantly among African American women, depending on socioeconomic variables. Targeting interventions to African American women, particularly those in lower socioeconomic groups, may increase knowledge of heart attack and stroke symptoms, subsequently improving preventive action taken in response to these conditions.

Stroke Knowledge and Barriers to Stroke Prevention Among African Americans: Implications for Health Communication

Stroke is a major cause of death and disability, especially among African Americans. Yet research on stroke knowledge and barriers to stroke prevention among African Americans is limited. This study used a 50-item questionnaire to conduct structured telephone interviews with 379 African American adults, 50 years or older. The questionnaire included questions on stroke knowledge, stroke risk behaviors, and barriers to stroke prevention. A stroke knowledge score was computed by assigning points for correct responses on knowledge items. The average stroke knowledge score of participants was 10.9, out of a maximum possible score of 27. Stroke knowledge was significantly related to the presence of hypertension, heart disease, diabetes, and family history of stroke. College education was significantly associated with older respondents' stroke knowledge. Younger college-educated respondents had more knowledge about the risky behaviors that lead to stroke than those with less education. Respondents preferred hospitals to churches or senior centers for receiving stroke information and for learning about stroke from their physicians. Stress and poor financialstatus were most frequently reported as barriers to stroke prevention. These findings have implications for developing more effective strategies for educating African Americans about stroke prevention.

Does reading about stroke increase stroke knowledge?: The impact of different print materials

The purpose of this study was to determine whether print materials on stroke resulted in increased knowledge in a sample of lay people. One hundred and seventy-seven participants received (at random) one of five versions of a stroke information packet, or a control packet on colorectal cancer. Participants rated the materials on readability, understandability and usefulness immediately after reading. After a delay of 18 days on average, participants answered questions assessing stroke knowledge. Ratings of all packets were generally positive; however, stroke knowledge scores were significantly higher for the stroke information groups compared to the control group only for knowledge of causal mechanisms (stroke pathophysiology). While there was some indication that the fictionalized material on stroke was more effective than the expository materials, overall the impact of print materials on stroke knowledge, measured after a delay of at least 1 week, was minimal at best. Further research is needed to determine whether fictional contexts make some information more memorable.