Browse > Article
http://dx.doi.org/10.14367/kjhep.2015.32.1.1

Effects of community-based education and advocacy intervention on public awareness about the warning signs of stroke and the golden window of time  

Lee, Young Hoon (Department of Preventive Medicine, Wonkwang University School of Medicine & Regional Cardiocerebrovascular Center, Wonkwang University Hospital)
Kim, Young Taek (Division of Infectious Disease Control, Korea Centers for Disease Control and Prevention)
Oh, Gyung Jae (Department of Preventive Medicine, Wonkwang University School of Medicine & Regional Cardiocerebrovascular Center, Wonkwang University Hospital)
Kim, Nam Ho (Division of Cardiology, Department of Internal Medicine, Wonkwang University School of Medicine)
Cho, Kwang Ho (Department of Neurology, Wonkwang University School of Medicine)
Park, Hyun Young (Department of Neurology, Wonkwang University School of Medicine)
Lee, Hak Seung (Department of Neurology, Wonkwang University School of Medicine)
Ha, Yeon Soo (Department of Neurology, Wonkwang University School of Medicine)
Cheong, Jin-Sung (Department of Neurology, Wonkwang University School of Medicine)
Park, Jin Ku (Regional Cardiocerebrovascular Center, Wonkwang University Hospital)
Lee, Kun Sei (Department of Preventive Medicine, School of Medicine, Konkuk University)
Kim, Hee Sook (Division of Chronic Disease Control, Korea Centers for Disease Control and Prevention)
Publication Information
Korean Journal of Health Education and Promotion / v.32, no.1, 2015 , pp. 1-10 More about this Journal
Abstract
Objectives: This study evaluated the effects and relevant factors of community-based education and advocacy intervention on stroke awareness among the general population. Methods: The study enrolled 505 community-dwelling adults aged 19 years or older who completed a survey before and after a community-based intervention held between May 2014 and December 2014. Trained staff collected data about knowledge of five stroke warning signs, emergency response, golden window of time (${\leq}3h$), and demographics. Results: After the intervention, public awareness of all five stroke warning signs increased significantly from 26.5% to 33.9% (p=0.011). Public awareness of the golden window of time also increased significantly from 70.1% in April 2014 to 75.8% in December 2014 (p=0.040). In a multivariate logistic regression analysis, older age, higher education level, and exposure to stroke-related public service announcements or educational materials were significant predictors of knowledge of all five warning signs for stroke. Conclusions: Comprehensive community-based intervention is effective for improving public awareness of the warning signs of stroke and the golden window of time.
Keywords
Stroke; Knowledge; Symptom; Population; Health education;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Lundelin, K., Graciani, A., Garcia-Puig, J., Guallar-Castillon, P., Taboada, J. M., Rodriguez-Artalejo, F., & Banegas, J. R. (2012). Knowledge of stroke warning symptoms and intended action in response to stroke in Spain: a nationwide population-based study. Cerebrovascular Diseases, 34(2), 161-168.   DOI   ScienceOn
2 Marx, J. J., Klawitter, B., Faldum, A., Eicke, B. M., Haertle, B., Dieterich, M., & Nedelmann, M. (2010). Gender-specific differences in stroke knowledge, stroke risk perception and the effects of an educational multimedia campaign. Journal of Neurology, 257(3), 367-374.   DOI
3 Mikulik, R., Goldemund, D., Rief, M., Brichta, J., Neumann, J., Jarkovsky, J., & Kryza, J. (2011). Calling 911 in response to stroke: no change following a four-year educational campaign. Cerebrovascular Diseases, 32(4), 342-348.   DOI   ScienceOn
4 Miyamatsu, N., Kimura, K., Okamura, T., Iguchi, Y., Nakayama, H., Toyota, A., . . . & Yamaguchi, T. (2012). Effects of public education by television on knowledge of early stroke symptoms among a Japanese population aged 40 to 74 years: a controlled study. Stroke, 43(2), 545-549.   DOI   ScienceOn
5 Mochari-Greenberger, H., Towfighi, A., & Mosca, L. (2014) National women's knowledge of stroke warning signs, overall and by race/ethnic group. Stroke, 45(4), 1180-1182.   DOI   ScienceOn
6 Muller-Nordhorn J., Wegscheider K., Nolte C. H., Jungehulsing G. J., Rossnagel K., Reich A., . . . & Willich S. N. (2009). Population-based intervention to reduce prehospital delays in patients with cerebrovascular events. Archives of Internal Medicine, 169(16), 1484-1490.   DOI   ScienceOn
7 Oser, C. S., Gohdes, D., Fogle, C. C., Tadios, F., Doore, V., Bell, D. S., . . . & Helgerson, S. D. (2013). Cooperative strategies to develop effective stroke and heart attack awareness messages in rural american Indian communities, 2009-2010. Preventing Chronic Disease, 10, E80.
8 Pandian, J. D., Kalra, G., Jaison, A., Deepak, S. S ., Shamsher, S., Singh, Y., & Abraham, G. (2006). Knowledge of stroke among stroke patients and their relatives in Northwest India. Neurology India, 54(2), 152-156.
9 Park, M. H., Jo, S. A., Jo, I., Kim, E., Eun, S. Y., Han, C., & Park, M. K. (2006). No difference in stroke knowledge between Korean adherents to traditional and western medicine - the AGE study: an epidemiological study. BioMed Central Public Health, 6, 153.   DOI
10 Rasura, M., Baldereschi, M., Di, Carlo. A., Di, Lisi. F., Patella, R., Piccardi, B., . . . & Inzitari, D. (2014). Promotion and Implementation of Stroke Care in Italy Project Working. Effectiveness of public stroke educational interventions: a review. European Journal of Neurology, 21(1), 11-20.   DOI   ScienceOn
11 Schneider, A. T., Pancioli, A. M., Khoury, J. C., Rademacher, E., Tuchfarber, A., Miller, R., . . . & Broderick, J. P. (2003). Trends in community knowledge of the warning signs and risk factors for stroke. Journal of the American Medical Association, 289(3), 343-346.   DOI   ScienceOn
12 Silver, F. L., Rubini, F., Black, D., & Hodgson, C. S. (2003). Advertising strategies to increase public knowledge of the warning signs of stroke. Stroke, 34(8), 1965-1968.   DOI   ScienceOn
13 Sug Yoon. S., Heller, R. F., Levi, C., Wiggers, J., & Fitzgerald, P. E. (2001). Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population. Stroke, 32(8), 1926-1930.   DOI   ScienceOn
14 Wahab, K. W., Okokhere, P. O., Ugheoke, A. J., Oziegbe, O., Asalu, A. F., & Salami, T. A. (2008). Awareness of warning signs among suburban Nigerians at high risk for stroke is poor: a cross-sectional study. BioMed Central Neurology, 8, 18.
15 Williams, L. S., Bruno, A., Rouch, D., & Marriott, D. J. (1997). Stroke patients' knowledge of stroke. Influence on time to presentation. Stroke, 28(5), 912-915.   DOI   ScienceOn
16 Worthmann, H., Schwartz, A., Heidenreich, F., Sindern, E., Lorenz, R., Adams, H. A., . . . & Dengler, R. (2013). Educational campaign on stroke in an urban population in Northern Germany: influence on public stroke awareness and knowledge. International Journal of Stroke, 8(5), 286-292.   DOI   ScienceOn
17 Zangerle, A., Kiechl, S., Spiegel, M., Furtner, M., Knoflach, M., Werner, P., . . . & Willeit, J. (2007). Recanalization after thrombolysis in stroke patients: predictors and prognostic implications. Neurology, 68(1), 39-44.   DOI   ScienceOn
18 Bray, J. E., Johnson, R., Trobbiani, K., Mosley, I., Lalor, E., & Cadilhac, D. (2013). Australian public's awareness of stroke warning signs improves after national multimedia campaigns. Stroke, 44(12), 3540-3543.   DOI   ScienceOn
19 Brice, J. H., Griswell, J. K., Delbridge, T. R., & Key, C. B. (2002). Stroke: from recognition by the public to management by emergency medical services. Prehospital Emergency Care, 6(1), 99-106.   DOI   ScienceOn
20 Derex, L., Adeleine, P., Nighoghossian, N., Honnorat, J., & Trouillas, P. (2002). Factors influencing early admission in a French stroke unit. Stroke, 33(1), 153-159.   DOI   ScienceOn
21 Evenson, K. R., Rosamond, W. D., & Morris, D. L. (2001). Prehospital and in-hospital delays in acute stroke care. Neuroepidemiology, 20(2), 65-76.   DOI   ScienceOn
22 Falavigna, A., Teles, A. R., Vedana, V. M., Kleber, F. D., Mosena, G., Velho, M. C., . . . & Roth, F. (2009). Awareness of stroke risk factors and warning signs in southern Brazil. Arquivos de Neuro-psiquiatria, 67(4), 1076-1081.   DOI
23 Fogle, C. C., Oser, C. S., McNamara, M. J., Helgerson, S. D., Gohdes, D., & Harwell, T. S. (2010). Impact of media on community awareness of stroke warning signs: a comparison study. Journal of Stroke and Cerebrovascular Diseases, 19(5), 370-375.   DOI   ScienceOn
24 Fussman, C., Rafferty, A. P., Lyon-Callo, S., Morgenstern, L. B., & Reeves, M. J. (2010). Lack of association between stroke symptom knowledge and intent to call 911: a population-based survey. Stroke, 41(7), 1501-1507.   DOI   ScienceOn
25 Gongora-Rivera, F., Gutierrez-Jimenez, E., & Zenteno, M. A. (2009). Knowledge of ischemic stroke among a Mexico City population. Journal of Stroke and Cerebrovascular Diseases, 18(3), 208-213.   DOI   ScienceOn
26 Gumbinger, C., Reuter, B., Stock, C., Sauer, T., Wietholter, H., Bruder, I., . . . & Hacke, W. (2014). Time to treatment with recombinant tissue plasminogen activator and outcome of strokein clinical practice: retrospective analysis of hospital quality assurance data with comparison with results from randomised clinical trials. British Medical Journal, 348, g3429.   DOI
27 Hartigan, I., O'Connell, E., O'Brien, S., Weathers, E., Cornally, N., Kilonzo, B., & McCarthy, G. (2014). The Irish national stroke awareness campaign: a stroke of success? Applied Nursing Research, 27(4), e13-e19.   DOI   ScienceOn
28 Hickey, A., O'Hanlon, A., McGee, H., Donnellan, C., Shelley, E., Horgan, F., & O'Neill, D. (2009). Stroke awareness in the general population: knowledge of stroke risk factors and warning signs in older adults. BioMed Central Geriatrics, 9, 35.   DOI   ScienceOn
29 Hodgson, C., Lindsay, P., & Rubini, F. (2007). Can mass media influence emergency department visits for stroke? Stroke, 38(7), 2115-2122.   DOI   ScienceOn
30 Kim, J., Hwang, Y. H., Kim, J. T., Choi, N. C., Kang, S. Y., Cha, J. K., . . . & Lim, B. H. (2014). Establishment of government-initiated comprehensive stroke centers for acute ischemic stroke management in South Korea. Stroke, 45(8), 2391-2396.   DOI   ScienceOn
31 Kim, Y. S., Park, S. S., Bae, H. J., Cho, A. H., Cho, Y. J., Han, M. K., . . . & Yoon, B. W. (2011). Stroke awareness decreases prehospital delay after acute ischemic stroke in Korea. BioMed Central Neurology, 11, 2.
32 Kim, W. J., Ko, Y., Park, J. H., Ban, B., Han, M. K., Cho, Y. J., & Bae, H. J. (2013). Validation of five cardinal symptoms used for stroke awareness campaign. Journal of the Korean Neurological Association, 31(1), 15-20. [Korean]
33 Kimura, K., Iguchi, Y., Shibazaki, K., Aoki, J., Watanabe, M., Matsumoto, N., & Yamashita, S. (2010). Early stroke treatment with IV t-PA associated with early recanalization. Journal of the Neurological Sciences, 295(1-2), 53-57.   DOI   ScienceOn
34 Lecouturier, J., Rodgers, H., Murtagh, M. J., White, M., Ford, G. A., & Thomson, R. G. (2010). Systematic review of mass media interventions designed to improve public recognition of stroke symptoms, emergency response and early treatment. BioMed Central Public Health, 10, 784.   DOI   ScienceOn
35 Lee, Y. H., Shin, M. H., Kweon, S. S., Choi, J. S., Park, M. S., Cho, K. H., & Lim, Y. S. (2012). Awareness of stroke warning signs and risk factors: result of a 2010 community survey in Gwangju metropolitan city. Journal of the Korean Neurological Association, 30(1), 26-32. [Korean]