Assessing Urban Community Knowledge of Acute Stroke: Results with a Culturally Sensitive Instrument

• Published in: Academic emergency medicine Vol. 10; no. 5; pp. 490 - 491
• Main Author: Manor, D. E
• Format: Journal Article
• Language: English
• Published: Des Plaines Wiley Subscription Services, Inc 01.05.2003
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1197/aemj.10.5.490-c

OBJECTIVE: Despite the recent development of time sensitive thrombolytic therapy for acute stroke, most patients do not seek medical care within the therapeutic window. Using a culturally appropriate instrument, we conducted interviews to assess our urban community's baseline knowledge of acute stroke, prior to developing a community-based educational intervention. METHODS: Trained interviewers administered a structured interview consisting of 15 open-ended questions regarding the causes of acute stroke, the identification of acute stroke symptoms, the urgency of calling 911, and preferred methods of stroke education. Interviews were conducted at NYC apartment buildings known to have a high stroke-risk population (i.e. over age 50). The consent and interview process required an average of 15 minutes to complete for each subject. Data were entered and analyzed using SPSS. RESULTS: 60 participants at 6 separate buildings completed interviews. Respondents were 72% female; 63% African-American; mean age 69 (SD = +/-16.2). 82% were unable to define stroke as occurring in the brain. Only 58% were able to name any warning sign of stroke; most frequently mentioned was numbness/weakness (43%) followed by slurred speech (18%). 42% failed to state "call 911" as the first thing they would do; 88% did not know the treatments available for stroke. 87% were interested in receiving stroke education; of these 38% preferred attending a lecture/workshop in their building, while 36% preferred reading a pamphlet. Level of education, gender, and age had no significant correlation with knowledge of stroke. CONCLUSIONS: In our urban community, knowledge regarding acute stroke and the importance of calling 911 is poor using a culturally sensitive instrument. The community appears to be highly motivated to improve its knowledge of stroke. Urban community-based education may improve stroke outcomes by earlier presentations of potential stroke patients to emergency departments.