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Rodrigues MDS, Santana LFE, Fernandes Castro AP, Almeida Coelho KK, Guimarães MP, Gomes OV, Schwingel PA, de Cerqueira RB, Guimarães MD, de Moura JC. Awareness towards stroke among high school students in Brazil: a cross-sectional study. SAO PAULO MED J 2022; 140:525-530. [PMID: 35508010 PMCID: PMC9491467 DOI: 10.1590/1516-3180.2021.0659.r2.13102021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Stroke is one of the main causes of death worldwide. Educational interventions on stroke are potentially effective in reducing the period between the onset of symptoms and the initial emergency medical assistance. OBJECTIVES To assess high school students' knowledge of stroke. DESIGN AND SETTING Cross-sectional study conducted in high schools in northeastern Brazil. METHODS A self-structured questionnaire survey regarding stroke awareness was applied among high school students in northeastern Brazil. Data were collected between 2018 and 2019. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS A total of 1,788 students were analyzed. Eighty percent (n = 1430) of them did not have the minimum knowledge on how to act in a stroke situation. Only 10% (n = 179) presented the ideal knowledge on how to act. Males presented lower levels of knowledge on risk factors (odds ratio, OR: 0.62%; 95% confidence interval, CI: 0.49-0.79) and signs and symptoms of stroke (OR: 0.63%; 95% CI: 0.52-0.77). Students with ≥ 10 years of schooling (OR: 1.64%; 95% CI: 1.30-2.07) demonstrated greater knowledge of signs and symptoms of stroke. Students aged 18 years (OR: 1.70%; 95% CI: 1.14-2.52) demonstrated greater knowledge than other ages regarding the telephone number of the emergency medical services. CONCLUSIONS There was a knowledge deficit with regard to recognizing stroke and activating the emergency medical services. The findings apply to the sample investigated and suggest that there is a need for stroke educational interventions, starting in high school.
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Affiliation(s)
- Mateus de Sousa Rodrigues
- Undergraduate Medical Student, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | | | | | | | - Manoel Pereira Guimarães
- Undergraduate Medical Student, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | - Orlando Vieira Gomes
- MSc. Professor, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | - Paulo Adriano Schwingel
- PhD. Professor, Human Performance Research Laboratory, Universidade de Pernambuco (UPE), Pernambuco (PE), Brazil
| | - Renato Bispo de Cerqueira
- MD. Professor, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | - Marcos Duarte Guimarães
- PhD. Professor, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
| | - José Carlos de Moura
- PhD. Professor, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil
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Calderaro M, Salles IC, Gouvêa GB, Monteiro VS, Mansur AP, Shinohara HNI, Aikawa P, Umeda IIK, Semeraro F, Carmona MJC, Böttiger BW, Nakagawa NK. The lack of knowledge on acute stroke in Brazil: A cross-sectional study with children, adolescents, and adults from public schools. Clinics (Sao Paulo) 2022; 77:100052. [PMID: 35777299 PMCID: PMC9253714 DOI: 10.1016/j.clinsp.2022.100052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/10/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Stroke is an important cause of disability and death in adults worldwide. However, it is preventable in most cases and treatable as long as patients recognize it and reach capable medical facilities in time. This community-based study investigated students' stroke knowledge, Emergency Medical Services (EMS) activation, associated risk factors, warning signs and symptoms, and prior experience from different educational levels in the KIDS SAVE LIVES BRAZIL project. METHODS The authors conducted the survey with a structured questionnaire in 2019‒2020. RESULTS Students from the elementary-school (n = 1187, ∼13 y.o., prior experience: 14%, 51% women), high-school (n = 806, ∼17 y.o., prior experience: 13%, 47% women) and University (n = 1961, ∼22 y.o., prior experience: 9%, 66% women) completed the survey. Among the students, the awareness of stroke general knowledge, associated risk factors, and warning signs and symptoms varied between 42%‒66%. When stimulated, less than 52% of the students associated stroke with hypercholesterolemia, smoking, diabetes, and hypertension. When stimulated, 62%‒65% of students recognized arm weakness, facial drooping, and speech difficulty; only fewer identified acute headache (43%). Interestingly, 67% knew the EMS number; 81% wanted to have stroke education at school, and ∼75% wanted it mandatory. Women, higher education, and prior experience were associated with higher scores of knowing risk factors (OR = 1.28, 95% CI: 1.10‒1.48; OR = 2.12, 95% CI: 1.87‒2.40; OR = 1.46, 95% CI: 1.16‒1.83; respectively), and warning signs- symptoms (OR = 2.22, 95% CI: 1.89‒2.60; OR = 3.30, 95% CI: 2.81‒3.87; OR = 2.04, 95% CI: 1.58‒2.63; respectively). CONCLUSION Having higher education, prior experience, and being a woman increases stroke-associated risk factors, and warning signs and symptoms identification. Schoolchildren and adolescents should be the main target population for stroke awareness.
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Affiliation(s)
- Marcelo Calderaro
- KIDS SAVE LIVES Brazil, Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Neurology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Igor C Salles
- KIDS SAVE LIVES Brazil, Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Cardiology Division, Instituto do Coração (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gabriela B Gouvêa
- KIDS SAVE LIVES Brazil, Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Cardiology Division, Instituto do Coração (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vinícius S Monteiro
- KIDS SAVE LIVES Brazil, Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Neurology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Antonio P Mansur
- KIDS SAVE LIVES Brazil, Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Cardiology Division, Instituto do Coração (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Henrique N I Shinohara
- KIDS SAVE LIVES Brazil, Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Cardiology Division, Instituto do Coração (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Priscila Aikawa
- Physiology Department, Faculdade de Medicina da Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Iracema I K Umeda
- KIDS SAVE LIVES Brazil, Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Physiotherapy Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Federico Semeraro
- Anaesthesia and Intensive Care Department, Ospedale Maggiore, Bologna, Italy
| | - Maria José C Carmona
- KIDS SAVE LIVES Brazil, Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Anesthesiology Discipline, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bernd W Böttiger
- Anaesthesiology and Intensive Care Medicine Department, University Hospital and Medical Faculty of the University Cologne, Cologne, Germany
| | - Naomi K Nakagawa
- KIDS SAVE LIVES Brazil, Education, Assessment and Intervention in Cardiopulmonary Group, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Physiotherapy Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
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Mannoh I, Turkson-Ocran RA, Mensah J, Mensah D, Yi SS, Michos ED, Commodore-Mensah Y. Disparities in Awareness of Myocardial Infarction and Stroke Symptoms and Response Among United States- and Foreign-Born Adults in the National Health Interview Survey. J Am Heart Assoc 2021; 10:e020396. [PMID: 34845927 PMCID: PMC9075376 DOI: 10.1161/jaha.121.020396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States. MI and stroke symptom awareness and response reduce delays in hospitalization and mortality. Methods and Results We analyzed cross‐sectional data from the 2014 and 2017 National Health Interview Surveys on US‐ and foreign‐born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). The outcomes were recommended MI and stroke knowledge, defined as knowing all 5 symptoms of MI or stroke, respectively, and choosing “call 9‐1‐1” as the best response. We included 63 059 participants, with a mean age 49.4 years; 54.1% were women, and 38.5% had a high school education or less. Recommended MI and stroke knowledge were highest in US‐born people. In both 2014 and 2017, MI knowledge was lowest in individuals born in Asia (23.9%±2.5% and 32.1%±3.3%, respectively), and stroke knowledge lowest for the Indian subcontinent (44.4%±2.4% and 46.0%±3.2%, respectively). Among foreign‐born adults, people from Russia and Europe had the highest prevalence of recommended MI knowledge in 2014 (37.4%±5.4%) and 2017 (43.5%±2.5%), respectively, and recommended stroke knowledge was highest in people from Europe (61.0%±2.6% and 67.2%±2.5%). Improvement in knowledge was not significant in all groups between 2014 and 2017. Conclusions These findings suggest a disparity in MI and stroke symptom awareness and response among immigrants in the United States. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.
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Affiliation(s)
- Ivy Mannoh
- School of Medicine Johns Hopkins University Baltimore MD
| | | | | | | | - Stella S Yi
- Grossman School of Medicine New York University New York NY
| | - Erin D Michos
- School of Medicine Johns Hopkins University Baltimore MD
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Umar AB, Koehler TJ, Zhang R, Gilbert V, Farooq MU, Davis AT, Nyenhuis D, Gorelick PB. Stroke knowledge among middle and high school students. J Int Med Res 2019; 47:4230-4241. [PMID: 31307252 PMCID: PMC6753559 DOI: 10.1177/0300060519858887] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective To determine the awareness of stroke symptoms and risk factors in middle and
high school students at a single institution. Methods An 11-question multiple-choice stroke awareness survey was administered to
students in grades 7 to 12 at City High Middle School in Grand Rapids,
Michigan, United States. Summary statistics were calculated. Results A total of 603/608 surveys were analyzed. Only 8% of respondents correctly
identified stroke as the fifth leading cause of death in the United States.
Half (50.1%) recognized that a stroke occurred in the brain. Sixty-seven
students (11.1%) correctly identified all 11 stroke risk factors. Only 5.1%
correctly selected all four correct stroke symptoms. Two-thirds (64.5%)
recognized stroke as an immediate medical emergency. Slightly more than half
(55.9%) knew the acronym FAST (face, arms, speech, time). Conclusions Most students in our study were unaware of all the risk factors and symptoms
related to stroke. Although this study was limited because data were
collected from only one school, the findings suggest a need to educate
middle and high school students about stroke risk factors, symptoms and
acute interventions.
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Affiliation(s)
| | - Tracy J Koehler
- Scholarly Activity Support, Spectrum Health, Grand Rapids, MI, United States
| | - Reian Zhang
- City High Middle School, Grand Rapids, MI, United States
| | | | - Muhammad U Farooq
- Mercy Health, Hauenstein Neurosciences, Grand Rapids, MI, United States
| | - Alan T Davis
- Scholarly Activity Support, Spectrum Health, Grand Rapids, MI, United States
| | - David Nyenhuis
- Mercy Health, Hauenstein Neurosciences, Grand Rapids, MI, United States
| | - Philip B Gorelick
- Mercy Health, Hauenstein Neurosciences, Grand Rapids, MI, United States and Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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