EMS programs improve stroke awareness, short-term

Community stroke education programs developed by emergency medical services (EMS) personnel help increase people's knowledge about the warning signs and symptoms of stroke, and are relatively inexpensive to implement, new research from West Virginia shows.

But when the interventions end, knowledge declines, and these interventions also didn't increase awareness of stroke risk factors or the need to call 911 if someone seems to be having a stroke, Stephen M. Davis of West Virginia University in Morgantown and his colleagues found.

Clot-dissolving or thrombolytic drugs available since 1996 can help reduce damage after stroke, but must be given within a short time after a stroke occurs, Davis and his team note in the June issue of Stroke. In fact, they add, just 2 percent to 6 percent of stroke patients who could benefit from such therapies actually get them.

"The reason why we came up with this idea was because a lot of the literature shows that you can teach the public about stroke signs and symptoms," Davis told Reuters Health. While mass media programs to improve knowledge about stroke have had some success, he added, these programs are very expensive; some communities spend upwards of $1 million on print and broadcast public service announcements. "In West Virginia, most of our communities don't have a million dollars," the researcher added.

Davis and his colleagues investigated whether it might be possible to deliver this information in a less costly way by working with local EMS personnel. In the first phase of their two-part study, they offered an educational course to EMS personnel in a single county, after which EMS workers broke into small groups and came up with ideas for 10 different educational materials to increase stroke awareness and 15 "strategic community locations" for placement of the information.

In the second phase, the researchers enrolled EMS personnel from four counties in the program and had four more counties serve as controls. Each of the intervention counties received $5,000 to help pay for educational materials, with instructions to make these materials reusable if possible.

Interventions the EMS personnel developed included posters put up in malls, pharmacies and tobacco shops and on city buses; a TV spot produced with the help of a local hospital; stroke awareness events; and strategies for distributing information at other community functions.

For phase 1, the researchers surveyed a total of 724 people about stroke signs and symptoms, stroke risk factors, and the need to call 911 before the intervention. The survey was repeated four more times during the following two years.

In the second phase, they surveyed 1,193 people in the control counties and 1,182 people in the counties where EMS personnel conducted stroke awareness programs.

After phase 1, the researchers observed an initial increase in awareness of warning signs and symptoms of stroke, followed by a decline after the intervention was over.