FAST Heroes: Results of Cross-Country Implementation of a Global School-Based Stroke Education Campaign

Value of the stroke 1-2-0 prehospital stroke education system: the experience of a general practitioner team

BACKGROUND

Stroke is one of the leading causes of death worldwide, especially in developing countries. In China, there is an urgent need to educate people about stroke awareness and the importance of using emergency medical services (EMS) quickly after a stroke has occurred.

OBJECTIVE

We sought to explore the effects of the Stroke 1-2-0 Prehospital Stroke Education System based on the experience of a general practitioner team.

METHOD

We prospectively enrolled 119 community general practitioners to be trained in the procedures advocated by the Stroke 1-2-0 Prehospital Stroke Education System. The training content included early detection of ischemic stroke, first aid for stroke, and intravenous thrombolysis; The effects of the training were later evaluated via a before-and-after comparison. The 119 enrolled physicians formed a Stroke 1-2-0 lecturer group and taught stroke knowledge to community residents. The group remained active for 6 months, during which the medical treatment data of stroke patients (i.e., stroke onset time, prehospital delay, whether an ambulance was called, and whether thrombolytic therapy was performed) in each of 5 jurisdictions were recorded for the month before (January 2021) and that after (August 2021) the 6-month community education program. Finally, the effects of the community education program were evaluated.

RESULTS

The participants' understanding of intravenous thrombolysis in the treatment of acute ischemic stroke improved significantly after the training as compared with their earlier understanding (96% vs. 78.99%; P < .001), and their understanding of the time window for intravenous thrombolysis increased from 26.05% before to 72% (P < .001) after the training. Most of the participants (90% vs. 67.23%; P < .001) said that they would immediately call the 120 emergency number of China's emergency phone system if they encountered individuals who appeared to be victims of acute stroke. A total of 82 stroke patients were seen before and 67 after the community education program. As for the use of the emergency call system, more patients with stroke activated that system after the program versus before (21.95% vs. 37.31%; P = .04). The 3-hour arrival rate after the program was nearly three times higher than that before the program (62.69% vs. 19.51%; P < .001). Also, regarding receiving thrombolysis after the occurrence of a stroke, the program triggered a substantial increase compared with the total earlier (19.4% vs. 6.1%; P = .013).

CONCLUSION

We found that the Stroke 1-2-0 Prehospital Stroke Education System significantly improved community residents' knowledge regarding stroke.

Continuity and Change in Baseline Stroke Knowledge across the world: Second Wave of FAST Heroes campaign implementation

OBJECTIVES

In this work we present the results of the implementation of a globally representative educational school-based stroke awareness programme, FAST (Face, Arm, Speech, Time) Heroes during the second year of education (wave 2). We aimed to observe changes in baseline stroke knowledge between wave 1 and wave 2, distinguish the more fine-grained effect of the campaign on society, and evaluate changes before and after the implementation of wave 2.

MATERIALS AND METHODS

In wave 2, parents of school-aged children completed an online stroke preparedness questionnaire before (t1) and after (t2) programme implementation. Results between the time points were analyzed with descriptive statistics alongside changes in baseline knowledge between waves 1 and 2.

RESULTS

1,611 parents participated in wave 2. Parents increased their knowledge of three stroke symptoms from 69% to 87% (p<.001). Their knowledge of the designated emergency number rose from 75% (t1) to 88% (t2) (p<.001). A 17% increase in baseline knowledge occurred in stroke symptoms identified correctly between wave 1 (11 countries) and 2 (18 countries).

CONCLUSIONS

Results support the precision and usability of the data collection approach in measuring the change in stroke knowledge between implementation waves. The increased baseline knowledge concerning stroke symptoms in wave 2 needs further examination.