Abstract WP215: Stroke Knowledge Over Time among Multi-ethnic Stroke Survivors in New York City

Background: Stroke knowledge, which includes awareness of symptoms, risk factors and treatment options, is critical to preventing stroke and improving outcomes. In recent years there have been significant state, federal, and private initiatives to improve “door to needle time” including efforts towards lay education about acute stroke as an emergency; however, their impact is unknown. We assessed stroke knowledge over time among mild/moderate stroke/TIA patients in New York City in two large clinical trials, the Stroke Warning Information and Faster Treatment (SWIFT) study and the Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) study.

Methods: Basline data from SWIFT was collected between 2005-2009 and for DESERVE between 2012-2016. Before randomization, patients were asked closed-ended questions focused on stroke symptoms, risk factors and preparedness behaviors. Proportions of correct responses were calculated and logistic regression was used to assess the change in knowledge over time while controlling for education, age, gender, and race/ethnicity. We also assessed whether stroke knowledge changed differentially over time by race or gender using product terms.

Results: A total of 1,190 participants from SWIFT and 552 from DESERVE were included in the analysis. The pooled sample was 50.1% female, 23.9% non-Hispanic black, 43.4% non-Hispanic white, and 48.4% Hispanic, mean age 64.3. The brain was correctly identified as the site where stroke occurs by 78.14%, all 5 symptoms of stroke were correctly identified by 40.64% (replying ‘yes’ to hemiparesis, hemisensory loss, difficulty speaking, blurred vision and ‘no’ to chest pain), and 6 or more risk factors were identified by 75.55% of participants in both cohorts. The odds of identifying the brain as the location of a stroke increased each year (OR=1.05, p<0.01) as did correctly identifying 6 or more risk factors of stroke (OR=1.03, p<0.01). Correct responses to all 5 symptoms did not significantly change over time. Knowledge over time did not change differentially by race or gender.

Conclusion: There was a small increase in stroke knowledge over time between 2005-2016 in our urban, multi-ethnic cohorts, though levels remain suboptimal.