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. 2023 Dec;54(12):3169-3172.
doi: 10.1161/STROKEAHA.123.044017. Epub 2023 Nov 2.

Temporal Trends in Public Stroke Knowledge, 1995-2021

David J Robinson  1 , Lili Ding  2 , Eric Rademacher  3 , Robert Stanton  1 , Aaron M Anderson  4 , Jane C Khoury  2 , Joseph P Broderick  1 , Brett M Kissela  1 , Dawn Kleindorfer  5
Affiliations

Temporal Trends in Public Stroke Knowledge, 1995-2021

David J Robinson et al. Stroke. 2023 Dec.

Abstract

Background: Outreach campaigns have sought to reduce the burden of stroke by improving knowledge of stroke risk factors (RF) and warning signs (WS). We describe trends in stroke knowledge from 1995 to 2021.

Methods: From 1995 to 2021, 6 separate surveys were conducted in the Greater Cincinnati Northern Kentucky Region. Temporal trends in RF/WS knowledge were analyzed using logistic regression adjusting for Race, sex, age, and education.

Results: In 1995, 28.6% of participants (537/1880) could name ≥2 WS, compared with 50.6% (983/1944) in 2021 (trend P<0.0001 after adjustment). In 1995, 44.5% of participants (836/1880) knew ≥2 RF, compared with 56.7% (1103/1944) in 2021 (trend P<0.0001 after adjustment). Although still improved compared with 1995, fewer participants could identify ≥2 RF in 2021 (1103/1944, 56.7%) when compared with 2011 (1287/2036, 63.2%, pairwise P<0.05). This decline in RF knowledge was disproportionately larger in women (odds ratio of 0.67 for knowledge in 2021 compared with 2011 in females, P=0.047 for the interaction between sex and study year).

Conclusions: Although stroke knowledge has overall improved since 1995, there is evidence for lost gains since 2011, particularly in women. Stroke outreach campaigns need ongoing evaluation.

Keywords: female; morbidity; reperfusion; risk factor; telephone.

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Conflict of interest statement

Disclosures Dr Kissela reports service on the Board of Directors for the American Academy of Neurology. The other authors report no conflicts.

Figures

Figure 1:
Figure 1:
Trends in knowledge of warning signs (A) and risk factors (B) over time adjusting for age, educational attainment, Race, and sex. 95% Confidence interval for estimate are given for each point estimate. Statistically significant pairwise comparisons after adjustment for multiple comparisons are labeled with P<0.05.
Figure 2:
Figure 2:
Decline in Stroke RF knowledge in 2021 vs 2011 by demographics. Abbreviations: i.e., the referent group is the odds in 2011). The significant interaction term between year and sex suggests that the decline in knowledge of stroke RF from 2011 to 2021 in female participants was greater than in male participants.
See this image and copyright information in PMC

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