Awareness of Stroke Signs and Symptoms and Calling 9-1-1 Among US Adults

National Health Interview Survey, 2009 and 2014

Ashruta Patel, DO, MS; Jing Fang, MD, MS; Cathleen Gillespie, MS; Erika Odom, PhD; Sallyann Coleman King, MD, MSc; Cecily Luncheon, MD, MPH, DrPH; Carma Ayala, RN, MPH, PhD

Disclosures

Prev Chronic Dis. 2019;16(6):e78 

In This Article

Abstract and Introduction

Abstract

Introduction: Early recognition of stroke symptoms and recognizing the importance of calling 9–1-1 improves the timeliness of appropriate emergency care, resulting in improved health outcomes. The objective of this study was to assess changes in awareness of stroke symptoms and calling 9–1-1 from 2009 to 2014.

Methods: We analyzed data among 27,211 adults from 2009 and 35,862 adults from 2014 using the National Health Interview Survey (NHIS). The NHIS included 5 questions in both 2009 and 2014 about stroke signs and symptoms and one about the first action to take when someone is having a stroke. We estimated the prevalence of awareness of each symptom, all 5 symptoms, the importance of calling 9–1-1, and knowledge of all 5 symptoms plus the importance of calling 9–1-1 (indicating recommended stroke knowledge). We assessed changes from 2009 to 2014 in the prevalence of awareness. Data analyses were conducted in 2016.

Results: In 2014, awareness of stroke symptoms ranged from 76.1% (sudden severe headache) to 93.7% (numbness of face, arm, leg, side); 68.3% of respondents recognized all 5 symptoms, and 66.2% were aware of all recommended stroke knowledge. After adjusting for sex, age, educational attainment, and race/ethnicity, logistic regression results showed a significant absolute increase of 14.7 percentage points in recommended stroke knowledge from 2009 (51.5%) to 2014 (66.2%). Among US adults, recommended stroke knowledge increased from 2009 to 2014.

Conclusion: Stroke awareness among US adults has improved but remains suboptimal.

Introduction

Stroke is the fifth leading cause of death in the United States. According to the American Heart Association, stroke kills nearly 140,000 people each year, accounts for 1 of every 20 deaths, and is the leading cause of long-term disability.[1] Public awareness of the symptoms of stroke and how to access emergency assistance is essential to increase the likelihood of achieving a favorable outcome. Several studies of public health campaigns for stroke awareness, including distribution of booklets and animations about early symptoms of stroke, have been conducted to improve population knowledge and decrease the likelihood of prehospital delays.[2,3]

The US Department of Health and Human Service's Healthy People 2020 (HP2020) includes heart disease and stroke objectives: 1) increase the prevalence of awareness of 5 early warning symptoms of a stroke, 2) increase the prevalence of awareness of the importance of accessing rapid emergency care by calling 9–1-1, and 3) increase the prevalence of awareness of both the 5 early warning symptoms of a stroke and the importance of accessing rapid emergency care by calling 9–1-1.

The prevalence by population of awareness of the signs of stroke has been reported.[4] We used National Health Interview Survey (NHIS) data to assess the change in awareness of stroke signs and symptoms from 2009 to 2014. Our objectives were to 1) examine changes in prevalence of awareness of stroke signs and symptoms from 2009 to 2014, 2) describe changes in prevalence of the HP2020 stroke awareness measures, and 3) examine sociodemographic and health-related factors associated with changes in prevalence of the HP2020 stroke awareness measures from 2009 to 2014.

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