Learning Objective #1: Describe the importance of completing an individual risk assessment for primary stroke prevention

Learning Objective #2: Quantify an individual's stroke risk using our risk assessment tool

---

Objectives: To design and pilot test a stroke risk assessment tool that (a) classifies individual stroke risk profiles, (b) provides follow-up recommendations based on risk, (c) provides education regarding the warning symptoms of stroke and (d) is practical for use in various settings.

Background: Stroke prevention strategies may reduce the incidence of stroke within at risk populations. Stroke risk assessment is one way to identify such populations.

Design: We developed our stroke risk assessment tool based on stroke risk factors indentified in epidemiological studies, specifically relative risk profiles from the Framingham Heart Study. Blood pressure management recommendations are based on JNCVI guidelines. Self report of risk factors combined with clinical findings of blood pressure and pulse are used to determine an individual's risk category. Side A of the tool is for data collection, risk categorization, and individual recommendations. Side B delineates stroke arning signs, emergency instructions, and lifestyle modification suggestions. The tool was pilot tested by nurse practitioners, registered nurses, pharmacists, paramedics and physicians who administered it to urban health fair participants.

Results: 495 stroke assessments were completed. Time trials revealed the mean time for completion, including education, regarding the warning signs for stroke was 2.5 minutes + 30 seconds. Early pilot testing identified the need for further clarification of criteria within the moderate risk category. 44% of the participants were >55 years; 76% African American, 24% Caucasian; 63% female and 36% male. Risk classification data reveals the majority of the participants carrying moderate stroke risks.

Conclusions: We developed a stroke risk assessment tool which stratifies stroke risk and provides specific recommendations based on stroke risk category. Unlike other risk assessment tools, it provides an educational interaction between administrator and participant for emergency response to stroke symptoms, and prevention strategies. Phase II testing for validity and reliability is underway.