Stroke awareness: surveillance, educational campaigns, and public health practice.

Stroke is a leading cause of death and disability in the United States. However, there is limited public knowledge about stroke signs and symptoms and the importance of seeking immediate medical care. Educational efforts such as stroke awareness campaigns are one way of informing the public about stroke symptoms and the need for early medical treatment following their onset. In this article, we present recent surveillance data concerning public awareness of stroke symptoms; summarize findings from 12 studies of the effectiveness of stroke awareness campaigns; and describe the efforts by three states to develop, implement, and evaluate heart disease and stroke programs, and the lessons to be learned from their experiences.

Changes in knowledge of stroke risk factors and warning signs among Michigan adults.

BACKGROUND: Increasing the public's awareness of stroke is a public health priority. Our objective was to assess changes in the public's knowledge of stroke risk factors and warning signs in Michigan during a 5-year period characterized by a sustained statewide public education effort. METHODS: Questions regarding knowledge of stroke risk factors and warning signs were included in the 1999 and 2004 Michigan Behavioral Risk Factor Surveys - random-digit-dialed statewide surveys of adults. Respondents were asked to report up to 3 risk factors and warning signs for stroke. RESULTS: Between 1999 and 2004, the proportion of respondents who reported 3 correct stroke warning signs increased substantially from 14.3 to 27.6% (p < 0.001), whereas the proportion reporting 3 correct risk factors remained almost unchanged (27.9 vs. 29.1%). The reporting of 2 warning signs in particular increased substantially over the 5-year period; 'any weakness or numbness' increased from 45.7 to 65.6%, while 'confusion, trouble speaking or understanding' increased from 29.9 to 46.5%. Knowledge of stroke warning signs increased across nearly all demographic subgroups, but remained poor for several high-risk groups including the elderly, minorities and those with less education. CONCLUSIONS: Knowledge of warning signs increased during this period while there was little change in knowledge of risk factors. The results suggest that these changes occurred in response to the public education campaign which focused primarily on warning signs. The findings further emphasize the need to target those subgroups who are at highest risk of stroke and where knowledge remains poorest.

Blood Pressure Sunday: introducing genomics to the community through family history.

BACKGROUND: Family history of a chronic disease, such as high blood pressure, is an important predictor of future disease. The integration of genomics information into public health activities offers the opportunity to help raise awareness among populations at high risk for high blood pressure. CONTEXT: The prevalence of high blood pressure in blacks at any age is about twice that of whites. Detroit is second among major U.S. cities in the percentage of residents who are black (81.6%). According to data from the Behavioral Risk Factor Surveillance System 1998-2002, the perceived health status of Detroit respondents was one of the worst in Michigan; 17.4% of Detroit respondents reported no health care coverage; 69.6% reported being obese or overweight; and 33.1% reported no physical activity. METHODS: The Michigan Department of Community Health and the University of Michigan's Center for Genomics and Public Health collaborated on a pilot program to develop a worksheet emphasizing the importance of personal family history of high blood pressure. The handout was distributed to individuals at primarily black, Detroit-area churches during an annual screening event for high blood pressure and stroke. CONSEQUENCES: Approximately 500 handouts were distributed; a collaborative effort was achieved; genomics information was integrated into an existing program; the ability to reach churches in a predominantly black community was demonstrated; consumers reported interest in the subject matter; and an appropriate literacy level for the handout was attained. INTERPRETATION: The strengths of this pilot program and suggested modifications may serve to guide others in genomics and/or chronic disease programs in future endeavors.