Literature Review: Research suggests that minorities have a higher incidence, prevalence, morbidity and mortality associated with stroke. This has been related to possessing a low knowledge and understanding of stroke/stroke risk factors and the urgent need to seek treatment. Attempts to educate communities about stroke and the need for timely intervention have not been routinely successful because of poor penetration into ethnic minority groups, education not culturally and ethnically sensitive, the high costs of mass media, lack of sustainability as well as the health disparities that exist within the diverse communities. The activation of 911 and the use of EMS transportation services when utilized by stroke patients have been independently associated with earlier emergency department (ED) arrival time, faster ED evaluation, faster treatment and more eligible patients treated with IV Alteplase if the stroke onset is < 2 hours. However, studies have reported that minority groups are less likely to activate 911. Available evidence suggests that these groups should be targeted with enhanced community education interventions to decrease pre-hospital delays that are associated with the non-use of EMS services.
Project Design: The study will employ a pre-post quasi-experimental design with a convenience sample of older urban adults in a community center in Brooklyn, NY. Data will be collected from a pre-test immediately before and a post-test immediately after a stroke education session. Data will be analyzed using descriptive & comparative statistics.
Implementation: The proposed intervention is a one-hour stroke education session using a PowerPoint presentation and videos. The educational objectives will include the identification and recognition of individual risk factors; description of stroke prevention measures; discussion of stroke symptoms; information on the need to treat stroke/new onset of symptoms as an emergency emphasizing the need for early intervention through the activation of calling 911. Information will be personalized through discussion and examples allowing participants to individually explore the experience of having a negative outcome and what it would mean to them & their lives.
Results: The results will provide evidence that an enhanced educational program related to stroke symptoms and risk factors will increase the KSAs in the urban older adult minority group resulting in timely activation of 911.
Implications: If successful, the proposed enhanced educational intervention can be embedded into other community-based stroke education programs. Further research is needed to establish if this intervention will assist in decreasing the morbidity and mortality associated with stroke.
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