Improving Community Stroke Preparedness in the HHS (Hip-Hop Stroke) Randomized Clinical Trial

Williams, Olajide; Quinn, Ellyn Leighton Herrmann; Teresi, Jeanne A.; Eimicke, Joseph P.; Kong, Jian; Ogedegbe, Gbenga; Noble, James M.

doi:10.1161/strokeaha.117.019861

Cited by 44 publications

(36 citation statements)

References 23 publications

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“…We do not know if these children were part of our study. Other studies have also reported activation of EMS by few children who underwent such education [ 11 , 12 ]. Children have also been shown to serve as an effective conduit for delivery of information in other stroke studies [ 13 - 15 ].…”

Section: Discussionmentioning

confidence: 99%

Make Kids Stroke-Smart: A Community Based Interventional Study

Nemade

Beckett

Nolte

et al. 2020

Cureus

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Background: Stroke is the third leading cause of death and the major cause of long-term disability in the United States. Timely recognition of symptoms is critical. Family members are crucial in recognizing stroke symptoms since <5% patients can call Emergency Medical Services themselves due to inability to speak or dial the phone. This might be of significance, especially, in family units where children have frequent contact with multiple generations. This study was undertaken to assess and improve the knowledge about stroke amongst children. Methods: A community-based interventional study was conducted among 305 kids ranging from second to eighth grade. A pre-test questionnaire was administered and later health education regarding stroke was imparted using audiovisual aids. Post-test was done to assess the impact of stroke education. Components of education included were: 1) What is stroke? 2) FAST mnemonic. 3) Time sensitive treatment. 4) Risk factors for stroke 5) How can they help? 6) Whom to call and where to go? The data was compiled and analyzed using Chi square test. Results: There was a significant lack of knowledge in the pretest groups. The post-test showed statistically significant improvement in all the tested components irrespective of age or grade (p<0.001). Conclusion: Targeting the younger generation for stroke education is one way to improve community knowledge of stroke symptoms thus increasing the chances that the stroke patient may receive acute stroke therapy. Children can also be used as a conduit to transmit educational information to parents and other family members thus further raising awareness.

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Section: Discussionmentioning

confidence: 99%

Make Kids Stroke-Smart: A Community Based Interventional Study

Nemade

Beckett

Nolte

et al. 2020

Cureus

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“…We deconstruct the MMHEM through the prism of an evidence-based intervention called Hip Hop Stroke (HHS)—a multisensory, culturally tailored, evidence-based intervention designed to increase stroke recognition and 911 calls (stroke preparedness) among urban minority children and their families [ 21 , 22 , 23 , 24 , 25 ]. Due to the disproportionately high stroke case fatality rates among United States (U.S.) Blacks, and the correspondingly low acute stroke treatment rates, HHS was developed to increase the stroke treatment rates among this group.…”

Section: Introductionmentioning

confidence: 99%

“…Hip Hop Stroke uses a novel multisensory, multimedia, and culturally tailored strategy to increase the appropriate behavioral action, which is to immediately call 911 in the event of a stroke, and thereby improve time-dependent acute stroke treatment rates. Importantly, HHS has been shown to be effective in a large randomized clinical trial (RCT) [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

A Multisensory Multilevel Health Education Model for Diverse Communities

Williams

Swierad

2019

IJERPH

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Owing to their enormous capacity to improve health and save lives, effective health promotion frameworks have been at the forefront of public health research and practice. A multilevel focus, as exemplified by the Socio-Ecological Model (SEM), is one common denominator among these frameworks. The SEM highlights important social and ecological influences on health behavior by delineating the different levels of influence. These include public policy, organizational, community, interpersonal, and intrapersonal levels, which, when considered during the development of health promotion campaigns, especially those that focus on health education, strengthen the potential influence of that campaign on targeted behaviors. However, the SEM lacks a complimenting framework for understanding the role of conventional and unconventional approaches to health education; that is, how to design a health education intervention that considers both the context, such as the social and ecological levels of influence, and the best approaches for developing and delivering the health education in a manner that optimizes their effectiveness in today’s modern and increasingly diverse world. Addressing this gap, the current article presents an integrative Multisensory Multilevel Health Education Model (MMHEM), which incorporates three key domains—(1) Art (innovativeness/creativity), (2) Culture (cultural tailoring), and (3) Science (evidence-based), while promoting the importance of considering the socio-ecological levels of influence on targeted behaviors. Using a successful health education intervention, called the Hip Hop Stroke, we deconstruct the Multisensory Multilevel Health Education Model and discuss its potential role as a guide for developing public health education interventions.

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“…Narrative communication has been shown to lower blood pressure in black individuals with hypertension, 6 increase HIV awareness and testing among Hispanic individuals, 7 and improve stroke preparedness among black and Hispanic youth. 8 Therefore, in an effort to improve and sustain stroke preparedness among at-risk black and Hispanic adults, a culturally tailored narrative communication intervention composed of 2 professionally produced 12-minute stroke films was created and successfully piloted. 9 A church setting was targeted because churches represent valuable delivery channels for behavior change programs in minority communities and experiential storytelling is a cornerstone of sermons.…”

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confidence: 99%

Effect of Stroke Education Pamphlets vs a 12-Minute Culturally Tailored Stroke Film on Stroke Preparedness Among Black and Hispanic Churchgoers

et al. 2019

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IMPORTANCE Black individuals and Hispanic individuals are less likely to recognize stroke and call 911 (stroke preparedness), contributing to racial/ethnic disparities in intravenous tissue plasminogen activator use. OBJECTIVE To evaluate the effect of culturally tailored 12-minute stroke films on stroke preparedness vs the usual care practice of distributing stroke education pamphlets. DESIGN, SETTING, AND PARTICIPANTS Cluster randomized clinical trial between July 26, 2013, and August 16, 2018, with randomization of 13 black and Hispanic churches located in urban neighborhoods to intervention or usual care. In total, 883 congregants were approached, 503 expressed interest, 375 completed eligibility screening, and 312 were randomized. Sixty-three individuals were ineligible (younger than 34 years and/or did not have at least 1 traditional stroke risk factor). INTERVENTIONS Two 12-minute stroke films on stroke preparedness for black and Hispanic audiences. MAIN OUTCOMES AND MEASURES The primary outcome was the Stroke Action Test (STAT), assessed at baseline, 6 months, and 12 months. RESULTS In total, 261 of 312 individuals completed the study (83.7% retention rate). Most participants were female (79.1%). The mean (SD) age of participants was 58.57 (11.66) years; 51.1% (n = 159) were non-Hispanic black, 48.9% (n = 152) were Hispanic, and 31.7% (n = 99) had low levels of education. There were no significant end-point differences for the STAT at follow-up periods. The mean (SD) baseline STAT scores were 59.05% (29.12%) correct for intervention and 58.35% (28.83%) correct for usual care. At 12 months, the mean (SD) STAT scores were 64.38% (26.39%) correct for intervention and 61.58% (28.01%) correct for usual care. Adjusted by education, a post hoc subgroup analysis revealed a mean (SE) intervention effect of 1.03% (0.44%) (P = .02) increase per month in the low-education subgroup (about a 10% increase in 12 months). In the high-education subgroup, the mean (SE) intervention effect was −0.05% (0.30%) (P = .86). Regarding percentage correct, the low-education intervention subgroup improved from 52.4% (7 of 21) to 66.7% (14 of 21) compared with the other subgroups. CONCLUSIONS AND RELEVANCE No difference was observed in stroke preparedness at 12 months in response to culturally tailored 12-minute stroke films or conventional stroke education pamphlets. Additional studies are required to confirm findings from a post hoc subgroup analysis that suggested a significant education effect.

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Improving Community Stroke Preparedness in the HHS (Hip-Hop Stroke) Randomized Clinical Trial

Abstract: URL: https://clinicaltrials.gov. Unique identifier: NCT01497886.

Cited by 44 publications

References 23 publications

Make Kids Stroke-Smart: A Community Based Interventional Study

Make Kids Stroke-Smart: A Community Based Interventional Study

A Multisensory Multilevel Health Education Model for Diverse Communities

Effect of Stroke Education Pamphlets vs a 12-Minute Culturally Tailored Stroke Film on Stroke Preparedness Among Black and Hispanic Churchgoers

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