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Iskandar K, Rahme D, Salameh P, Haddad C, Sacre H, Bahlol M, Darwish RM, El Khatib S, Safwan J, Sakr F, Rahhal M, Hosseini H, Cherfane M. Evaluating the influence of a 3-min online video on the community knowledge of stroke in four Arab countries. Front Public Health 2024; 12:1342490. [PMID: 38841682 PMCID: PMC11151891 DOI: 10.3389/fpubh.2024.1342490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Studies from developed and developing countries showed that the knowledge levels of stroke need improvement. Educational campaigns varied and were of limited influence predominantly because of their short duration and the need for financial support. The study aims to test the impact of a 3-min online video on the knowledge of stroke and factors influencing the knowledge score in four Arab countries. Methods A cross-sectional web-based pre-post study was conducted in Egypt, Jordan, Lebanon, and the United Arab Emirates. The data were collected using the snowball technique. Participants were adults aged 18 years and above. The questionnaire sequence was conducting a pretest, followed by the educational video explaining stroke occurrence, types, risks, warning signs, preventive measures, and treatment, and finally, a posttest to evaluate the differences in knowledge from baseline. Statistical analysis included paired t-tests comparing pre-post-education stroke knowledge scores, while repeated measures ANOVA, adjusting for covariates, assessed mean changes. Results The total number of participants was 2,721, mainly younger than 55 years. The majority had a university degree and were not healthcare professionals. A significant improvement was noted in the total knowledge score in all countries from a mean average (Mpretest = 21.11; Mposttest = 23.70) with p < 0.001. Identification of the stroke risks (Mpretest = 7.40; Mposttest = 8.75) and warning signs (Mpretest = 4.19; Mposttest = 4.94), understanding the preventive measures (Mpretest = 5.27; Mposttest = 5.39) and the importance of acting fast (Mpretest = 0.82; Mposttest = 0.85) improved from baseline with (p < 0.001) for all score components. Conclusion The educational tool successfully enhanced public understanding of stroke risks, the identification of stroke signs, and the critical need for emergency action. The advantages of this video include its short length, free online access, use of evidence-based content in lay language, and reflective images. The ultimate goal remains the long-term improvement of sustainability by mandating full-scale trials.
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Affiliation(s)
- Katia Iskandar
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Department of Health and Social Work, School of Public Health, Lebanese University, Fanar, Lebanon
- Higher Institute of Public Health (ISSP), Saint Joseph University of Beirut, Beirut, Lebanon
| | - Deema Rahme
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Department of Pharmacy Practice, School of Pharmacy, Beirut Arab University, Beirut, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Egypt
- Department of Pharmaceutical management and economics, Department Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Egyptian Russian University, Badr city, Cairo governorate, Egypt
| | - Mohamed Bahlol
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Rula M. Darwish
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, Paris, France
| | - Sarah El Khatib
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Department of Health and Social Work, School of Public Health, Lebanese University, Fanar, Lebanon
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, Paris, France
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, Paris, France
| | - Mohamad Rahhal
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hassan Hosseini
- INSERM U955-E01, IMRB, Henri Mondor Hospital, Créteil, France
- Department of Neurology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Michelle Cherfane
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Environmental and Public Health Department, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
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Bo Y, Zhu Y, Zhang X, Chang H, Zhang J, Lao XQ, Yu Z. Spatiotemporal Trends of Stroke Burden Attributable to Ambient PM 2.5 in 204 Countries and Territories, 1990-2019: A Global Analysis. Neurology 2023; 101:e764-e776. [PMID: 37380431 PMCID: PMC10437020 DOI: 10.1212/wnl.0000000000207503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/21/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Previous studies suggested that long-term exposure to ambient fine particulate matter (PM2.5) is associated with increased risk of stroke. However, limited studies evaluated the stroke burden attributable to ambient PM2.5 globally, especially comprising across different regions, countries, and social-economic levels. We thus conducted this study to estimate the spatial and temporal trends of ambient PM2.5-related stroke burden by sex, age, and subtypes from 1990 to 2019 at global, regional, and national levels. METHODS Information on the ambient PM2.5-related stroke burden from 1990 to 2019 was obtained from the Global Burden of Disease study 2019. The burdens of stroke attributable to ambient PM2.5 (i.e., age-standardized mortality rate [ASMR] and age-standardized disability-adjusted life-year rate [ASDR]) were estimated by sex, age, and subtypes from 1990 to 2019 at global, regional, and national levels. The estimated annual percentage change (EAPC) was used to evaluate the changing trends of ASDR and ASMR attributable to ambient PM2.5 from 1990 to 2019. The Spearman correlation coefficient was used to examine the correlation between sociodemographic index (SDI) and EAPC of ASMR and ASDR at the national level. RESULTS In 2019, the global ambient PM2.5-related stroke mortality and disability-adjusted life years were 1.14 million and 28.74 million, respectively, with the corresponding ASDR and ASMR of 348.1 and 14.3 per 100,000 population, respectively. The ASDR and ASMR increased with age and were highest among male patients, in the middle SDI regions, and for intracerebral hemorrhage (ICH). From 1990 to 2019, the absolute death number of stroke attributable to ambient PM2.5 and the corresponding ASMR and ASDR were both in an increasing trend. The corresponding EAPCs in ASMR and ASDR were 0.09 (95% CI -0.05 to 0.24) and 0.31 (95% CI 0.18-0.44), respectively. The significant increases of ASMR and ASDR were observed in the low, low-middle, and middle SDI regions, and for ICH. However, a decreasing trend was observed in high and middle-high SDI regions, and for subarachnoid hemorrhage. DISCUSSION The global burden of stroke attributable to ambient PM2.5 showed an increasing trend over the past 30 years, especially in male patients, low-income countries, and for ICH. Continued efforts on reducing the level of ambient PM2.5 are necessary to reduce the burden of stroke.
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Affiliation(s)
- Yacong Bo
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Yongjian Zhu
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Xiaoan Zhang
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Hui Chang
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Junxi Zhang
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Xiang Qian Lao
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong
| | - Zengli Yu
- From the School of Public Health (Y.B., Z.Y.), Zhengzhou University; Department of Cardiology (Y.Z.), The First Affiliated Hospital of Zhengzhou University; The Third Affiliated Hospital of Zhengzhou University (X.Z., H.C.); NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention (J.Z.), Zhengzhou, China; and Department of Biomedical Sciences (X.Q.L.), City University of Hong Kong, Kowloon Tong.
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Tsakpounidou K, van der Merwe J, Klinke ME, Webb C, Ouriques Martins SC, Proios H. FAST Heroes: Results of Cross-Country Implementation of a Global School-Based Stroke Education Campaign. Front Public Health 2022; 10:849023. [PMID: 35509512 PMCID: PMC9058110 DOI: 10.3389/fpubh.2022.849023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundEducating the at-risk population about stroke symptoms and requirement of calling an ambulance when stroke strikes is challenging. This exploratory cross-country study provides insights to the FAST Heroes educational campaign and outcomes hitherto achieved.AimsThe primary aim of the study was to measure the transfer of stroke-related knowledge to parents after a global school-based FAST Heroes educational campaign for 5- to 9-year-old children in 14 different countries. The secondary aim was to evaluate parents and teachers' acceptability toward the program.MethodsThe duration of the program was 5 h; 1 h per week, joining face-to-face educational sessions with workbooks, cartoons, web-based learning, and other fun activities. Outcomes were measured before implementation (t1), after implementation (t2), and at 6-month follow-up (t3). Program acceptability and stroke knowledge were evaluated by feedback surveys for teachers and parents.ResultsWorldwide, 4,202 parents completed the program with their children and answered surveys at t1 and t2. They increased their knowledge of three stroke symptoms from 48 to 83% (p < 0.001). All three surveys were completed by 86 parents, who improved their knowledge of stroke symptoms, 55% (t1), 79% (t2), and 94% (t3) (p < 0.001). Overall, the educational messages were successfully passed onward.ConclusionsFindings confirm the primary aim of the study that is knowledge about stroke transfer well from children to their families through the FAST Heroes program. Second, parents and teachers globally consider the program feasible and worthwhile. The results will inform further rollout of the campaign.
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Affiliation(s)
- Kalliopi Tsakpounidou
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
- *Correspondence: Kalliopi Tsakpounidou
| | - Jan van der Merwe
- Boehringer Ingelheim International Gesellschaft mit Beschränkter Haftung (GmbH), Healthcare Affairs and Patient Engagement, Ingelheim am Rhein, Germany
| | | | | | - Sheila Cristina Ouriques Martins
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Hospital Moinhos de Vento, Neurology, Porto Alegre, Brazil
| | - Hariklia Proios
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
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