Awareness of the risk factors of stroke among non-teaching staff of the Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria

Background The prevalence of stroke is increasing in Nigeria due to a lack of awareness of their predisposing factors. There is therefore a need for good knowledge and awareness of stroke risk factors in the general populations. Thus, this study assessed the level of awareness of stroke risk factors among non-teaching staff in Nnamdi Azikiwe University, Nnewi Campus, Nigeria. Results Most of the participants were female, 89 (69%), and had a post-graduate degree, 84 (65.1%). A total of 129 participants participated in this survey, and 91 (70.5%) were familiar with the term “stroke.” The commonest risk factors were high blood pressure (86%), stress (74.4%), and lack of exercise (63.6%). The study showed that the awareness of stroke risk factors among the participants was poor (40.3%). Conclusion Stroke awareness was poor among the participants with the highest risk of stroke despite their high literacy level. Female participants, with a postgraduate level qualification and working as senior non-teaching staff, had a better awareness of stroke risk factors than their male colleagues. This shows a need to increase stroke awareness campaigns in the community.

Abstract 1122‐000221: High School Student Stroke Awareness in Rio De Janeiro

Introduction : The ultimate purpose of this study was to assess the extent of stroke awareness within high school students in several countries in Latin America. Stroke awareness and prevention is the best way to minimize the risks of a stroke. Strokes resulted in 195,661 deaths in 2016 in high‐income regions within North America. In Brazil alone, there were 107,258 deaths by stroke in 2016 that could have been caused by improper treatment and lack of awareness. Methods : The focus of the study quickly shifted to within Brazil, due to its concerning status. Quantitative data provided by secondary and primary research through an anonymous survey shows a critical need for more awareness in high school students. A Google Form survey was conducted in 2020 with various multiple choice, checkbox, and multiple‐choice grid questions on 124 high school students in Brazil was passed out through several students in the area. Of these students, 83% were from a private high school with excellent academics, student life, and club activities, in the city of Rio de Janeiro. The impact of Covid‐19 has resulted in fewer responses from schools and officials as many were not taking any messages, making it difficult to attain survey responses. Results : Regardless, 26.61% of all survey participants were unaware of what a stroke is, and a majority thought it had to do with the heart. Less than half of the participants knew what FAST stood for, a well‐known acronym for identifying symptoms of a stroke. Even if a student identified a stroke, 25% did not know that the first step is calling an emergency hotline, crucial knowledge that could lead to a decrease in the high rate of stroke deaths. When asked where their knowledge of strokes came from, further concerns arose with more than half learning from social media, 12.39% not knowing anything, and 6.45% even citing Grey’s Anatomy, a popular television series. Only 37.1% of participants got any of their knowledge on stroke from the news and less than half learned from a credible source, such as their school. Conclusions : Lack of education about stroke among a significant number of students in Rio de Janeiro may lead to an increase in the number of stroke deaths that could have been prevented had communities been educated. The research marks the beginning of an ongoing assessment that will expand to all of Latin America. The assessment will reveal the extent of stroke awareness among the youth in the entire region and may provide a blueprint for educating them, ultimately improving the treatment rates for stroke in the region.

Abstract 1122‐000239: Understanding The Gap in Public Stroke Awareness in India’s Younger Generation

Introduction : Stroke is one of the major leading causes of death and disability in India. One reason is the lack of stroke awareness in India. With the adoption of an unhealthy lifestyle like a lack of physical exercise, smoking, and excessive alcohol consumption, newer stroke cases are more prevalent in young adults. I surveyed about 100 high school students from urban cities in India to assess their stroke knowledge and decide how to take measures to bring more awareness about its symptoms, risk factors, and new effective treatments. Methods : I randomly selected high school students(9th‐12th graders) from Uttarakhand, Uttar Pradesh, Madhya Pradesh, Maharashtra, and Karnataka states to participate in the survey I created. I distributed multiple‐choice anonymous questionnaires to hundreds of high school students. The participants completed survey questions to the best of their ability. The survey assessed candidates' demographic characteristics, knowledge of stroke symptoms, stroke risk factors, ability to identify stroke symptoms, and knowledge about stroke‐related surgeries. It is important to note that these surveys were primarily sent to high school students in urban areas, where the knowledge and resources are relatively better than the rural areas. Results : I received a total of 91 survey responses from high schoolers across different states in India (30% were from Madhya Pradesh, 40% were from Maharashtra and 30% were from Karnataka and Uttar Pradesh). Even though 53.8% of the respondents reported some level of prior knowledge about the stroke, the rest of the respondents simply did not know or had misconceptions about stroke. Nearly ¾ did not know any stroke risk factors, warning signs, or recognize that the brain gets affected during the stroke. Only 27.5% of the students have heard of the popular acronym BE FAST(Balance Eyes Face Arms Speech Time) which is used to detect stroke in a patient. It is shocking that only 12.1% of the respondents have received an education on stroke at least once in their lifetime. Conclusions : The high schoolers have a good recognition of some basic facts of stroke. However, they have a poor understanding of stroke risk factors, the severity of the disease, and the treatment availability. However, there is hope. More than 57% of the high schoolers in my survey mentioned that they were willing to learn about stroke and ways to prevent and detect it. So it is our duty to educate the younger generation about the dangers of stroke and how to prevent, as well as to detect it. We should strive to provide access to these children in the hope of helping spread awareness all around India one step at a time.

The Effectiveness of Stroke Riskometer™ in Improving Stroke Risk Awareness in Malaysia: A Study Protocol of a Cluster-Randomized Controlled Trial

<b><i>Background:</i></b> Stroke is considered the second leading cause of mortality and disability worldwide. The increasing burden of stroke is strong evidence that currently used primary prevention strategies are not sufficiently effective. The Stroke Riskometer^™ application (app) represents a new stroke prevention strategy distinctly different from the conventional high-cardiovascular disease risk approach. <b><i>Objective:</i></b> This proposed study aims to evaluate the effectiveness of the Stroke Riskometer^™ app in improving stroke awareness and stroke risk probability amongst the adult population in Malaysia. <b><i>Methods:</i></b> A non-blinded, parallel-group cluster-randomized controlled trial with a 1:1 allocation ratio will be implemented in Kelantan, Malaysia. Two groups with a sample size of 66 in each group will be recruited. The intervention group will be equipped with the Stroke Riskometer^™ app and informational leaflets, while the control group will be provided with standard management, including information leaflets only. The Stroke Riskometer^™ app was developed according to the self-management model of chronic diseases based on self-regulation and social cognitive theories. Data collection will be conducted at baseline and on the third week, sixth week, and sixth month follow-up via telephone interview or online questionnaire survey. The primary outcome measure is stroke risk awareness, including the domains of knowledge, perception, and intention to change. The secondary outcome measure is stroke risk probability within 5 and 10 years adjusted to each participant’s socio-demographic and/or socio-economic status. An intention-to-treat approach will be used to evaluate these measures. Pearson’s χ² or independent <i>t</i> test will be used to examine differences between the intervention and control groups. The generalized estimating equation and the linear mixed-effects model will be employed to test the overall effectiveness of the intervention. <b><i>Conclusion:</i></b> This study will evaluate the effect of Stroke Riskometer^™ app on stroke awareness and stroke probability and briefly evaluate participant engagement to a pre-specified trial protocol. The findings from this will inform physicians and public health professionals of the benefit of mobile technology intervention and encourage more active mobile phone-based disease prevention apps. <b><i>Trial Registration:</i></b> ClinicalTrials.gov Identifier NCT04529681.

Influencing Factors of Stroke Awareness Among Hypertensive Patients in Community Health Centers in Indonesia

The global burden of stroke is still high, particularly in developing countries, with hypertension serves as the main risk factor. Knowledge related to stroke is essential to establish better prevention strategies. This study aimed to identify factors associated with stroke awareness among hypertensive patients in Indonesia. This was a cross-sectional study conducted in five Community Health Centers in Indonesia. We used a standardized questionnaire to asses stroke awareness and the influencing factors. The knowledge on hypertension was assessed using Hypertension Knowledge Level Scale (HK-LS). Multivariate logistic regression analysis was performed to measure factors associated with stroke awareness. A total of 457 hypertensive patients were included. Majority of patients (77.46%) had low stroke awareness. Having higher knowledge on hypertension, higher income, and a history of previous stroke were associated with higher level of stroke awareness (odds ratio [OR] 1.878, 95%CI 1.176-2.999, p 0.008; OR 1.887, 95%CI 1.170-3.045, p 0.009; OR 5.276, 95%CI 2.210-12.594, p&lt;0.001, respectively). This study suggests that knowledge on hypertension, income, and history of previous stroke are factors which may influence the level of stroke awareness. This emphasizes the need to provide better campaign and education program to raise stroke awareness in a community setting.

Stroke in Sri Lanka: How Can We Minimise the Burden?

The burden of stroke in Sri Lanka is high and steadily increasing. Accurate estimation of the burden is hampered by a paucity of epidemiological data. More neurologists, stroke units, facilities for modern treatments and multi-disciplinary rehabilitation services are urgently needed. Essential drugs for risk factor control and secondary prevention are available in many hospitals. Aggressive preventive strategies and promoting stroke awareness are the best ways to minimise the stroke burden in Sri Lanka.

Abstract 48: An Updated Early Stroke Recognition Tool for the Inclusivity of Spanish-Speakers: RAPIDO

Background and Issues: Hispanics have higher stroke incidence and recurrence and are less likely to know the signs and symptoms of stroke compared to non-Hispanic Whites. Stroke awareness education promotes the recognition of the common signs and symptoms of stroke and subsequent treatment-seeking behaviors resulting in improved outcomes. Acronyms have been created to bring awareness to key stroke sign and symptom indicators; however, there are discrepancies when translating existing acronyms for Spanish-speakers. Purpose: The purpose of this project was to create and update a stroke awareness acronym for the inclusivity of Spanish-speakers. Methods: We searched the literature and were unable to identify translations of the commonly publicized FAST or BE-FAST acronyms into recognizable and relatable Spanish words across various dialects. Led by a Spanish-speaking nurse with experience working with stroke patients, our research team identified Spanish words that are used across various dialects for the translation of the BE-FAST acronym (balance, eyes, face, arm, speed, and time). Diverse Spanish-speaking members of our research team incorporated relatable images and reviewed the translated acronym for content and clarity. Results: We created the acronym RAPIDO for Spanish-speakers. Similar to FAST and BE-FAST, RAPIDO illustrates warning signs and symptoms of stroke and the need to seek treatment quickly. Conclusions: The creation of the RAPIDO acronym constitutes an important step in providing stroke awareness education to Spanish-speakers. If validated with the broader healthcare professional and lay community, adding the RAPIDO acronym to public stroke educational programs may be warranted.