Background and Purpose: Despite advances in stroke therapy, the public remains uninformed about stroke, and few stroke patients present to the hospital in time to receive treatment. Health education campaigns can increase community awareness and may decrease time to hospital presentation among stroke patients. Methods: We conducted a community-based education campaign utilizing television and newspapers to inform the residents of King County, Wash., USA, about stroke and the need to call 911. The effectiveness of the campaign was assessed, using a pretest-posttest design, through telephone interviews with residents of King County. Results: Prior to the education campaign, 59.6% of persons in King County could name a risk factor for stroke, but only 45.2% knew that the brain was the organ of injury. And while 68.2% of persons stated that they would call 911 in the event of stroke, only 38.6% could name a symptom of stroke. The knowledge deficit was greatest among Asian-Americans, men, the less educated and low-income residents. There was a significant increase in stroke knowledge following the education campaign; respondents were 52% (p = 0.005) more likely to know a risk factor for stroke and 35% (p = 0.032) more likely to know a symptom of stroke after the campaign. Conclusions: Baseline knowledge about stroke among the public is poor, but can be increased through public education campaigns.

Background and Purpose-Depression after stroke is prevalent, diminishing recovery and quality of life. Brief behavioral intervention, adjunctive to antidepressant therapy, has not been well evaluated for long-term efficacy in those with poststroke depression. Methods-One hundred one clinically depressed patients with ischemic stroke within 4 months of index stroke were randomly assigned to an 8-week brief psychosocial-behavioral intervention plus antidepressant or usual care, including antidepressant. The primary end point was reduction in depressive symptom severity at 12 months after entry. Results-Hamilton Rating Scale for Depression raw score in the intervention group was significantly lower immediately posttreatment (PϽ0.001) and at 12 months (Pϭ0.05) compared with control subjects. Remission (Hamilton Rating Scale for Depression Ͻ10) was significantly greater immediately posttreatment and at 12 months in the intervention group compared with the usual care control. The mean percent decrease (47%Ϯ26% intervention versus 32%Ϯ36% control, Pϭ0.02) and the mean absolute decrease (Ϫ9.2Ϯ5.7 intervention versus Ϫ6.2Ϯ6.4 control, Pϭ0.023) in Hamilton Rating Scale for Depression at 12 months were clinically important and statistically significant in the intervention group compared with control. Conclusion-A brief psychosocial-behavioral intervention is highly effective in reducing depression in both the short and long term.

Background-Depression is a sufficiently common sequela of a completed stroke to warrant intervention to improve mood, social and functional outcome. Pharmacologic trials suggest shortterm mood improvement from antidepressant treatment but no studies to date have determined