Effects of a Public Education Campaign on the Association Between Knowledge of Early Stroke Symptoms and Intention to Call an Ambulance at Stroke Onset: The Acquisition of Stroke Knowledge (ASK) Study

Abstract

BackgroundAn immediate ambulance call offers the greatest opportunity for acute stroke therapy. Effectively using ambulance services requires strengthening the association between knowledge of early stroke symptoms and intention to call an ambulance at stroke onset, and encouraging the public to use ambulance services.MethodsThe present study utilized data from the Acquisition of Stroke Knowledge (ASK) study, which administered multiple-choice, mail-in surveys regarding awareness of early stroke symptoms and response to a stroke attack before and after a 2-year stroke education campaign in two areas subject to intensive and moderate intervention, as well as in a control area, in Japan. In these three areas, 3833 individuals (1680, 1088 and 1065 participants in intensive intervention, moderate intervention, and control areas, respectively), aged 40 to 74 years, who responded appropriately to each survey were included in the present study.ResultsAfter the intervention, the number of correctly identified symptoms significantly associated with intention to call an ambulance (P < 0.05) increased (eg, from 4 to 5 correctly identified symptoms), without increasing choice of decoy symptoms in the intensive intervention area. Meanwhile, in other areas, rate of identification of not only correct symptoms but also decoy symptoms associated with intention to call an ambulance increased. Furthermore, the association between improvement in the knowledge of stroke symptoms and intention to call an ambulance was observed only in the intensive intervention area (P = 0.009).ConclusionsOur results indicate that intensive interventions are useful for strengthening the association between correct knowledge of early stroke symptoms and intention to call an ambulance, without strengthening the association between incorrect knowledge and intention to call an ambulance.

A Systematic Review of Tests Assessing Stroke Knowledge

“…34 Therefore, comprehensive SK concepts may need to include issues over one's entire life course 35 and encompass the epidemiology, risk factors, warning signs, emergency response, symptoms, and treatment/ rehabilitation of stroke, as well as concepts relevant to the long-term care, disability prevention, and health promotion. 36 Because SK covers multidimensional concepts across the continuum of stroke management, the framework proposed by the European Commission has the potential to be the basis for validating current SK tests and developing or refining additional tests.…”

Stroke identification by criteria based dispatch – a register based study

“…Studies have shown that GPs tend to have a lower prediction level of stroke than paramedics and EMS physicians. Nishikawa et al found an increased association between stroke symptom knowledge and intention to call an ambulance after a 2 year long stroke education campaign in Japan. A 2015 systematic review on stroke warning campaign studies found that although a majority reported positive intervention effects, the generalizability were limited because of methodological weaknesses.…”

Public stroke education: Current status worldwide and projects to increase awareness in the Czech Republic

“…Téměř všechny tyto kampaně se zaměřovaly obecně na dospělou populaci. V některých případech [4,5,21,22,24,27,28] ovšem studie hodnotily vliv kampaní v některých vybraných věkových skupinách. Tři studie [25,30,31] jsou školní programy zaměřené na děti a dvě [32,34] zahrnují i rodiče těchto dětí.…”