[Evaluation of the public-health intervention "Healthy Lower Rhine ... against Stroke" by phone surveys. A comparison of community knowledge of stroke by two surveys in the Lower Rhine Region, district of Wesel, Germany, 2002 and 2008].
OBJECTIVE
From 2003 to 2008, the program "Healthy Lower Rhine ... against Stroke" was carried out by the Healthy Lower Rhine Network consisting of Health-Conference agencies of six neighboring districts and municipalities. The initiative aims primarily at improving public knowledge on stroke with regard to proper action - "A stroke is a medical emergency, so phone the emergency number 112 immediately!" - and stroke warning signs and symptoms. The campaign is designed to eventually reduce prehospital time, i.e., delays from onset of symptoms to hospital delivery. In the Wesel district (North Rhine-Westphalia [NRW]) the local Health Conference commissioned two representative telephone surveys with a T(0) survey before the start of the program in 2003 and T(1) in 2008 prior to the end of the 5 years' runtime.


METHODS
The telephone survey was carried out by the CATI Laboratory (Computer-Assisted Telephone Interviews) of the Survey Center for Social Science (SUZ) in Duisburg in collaboration with the Institute of Health and Work NRW (LIGA.NRW) and the Health-Conference agency of the Wesel district. The study population was the adult community with about 385,000 inhabitants. The random sample comprised 1,089 persons for the T(0) survey (02/18/02-03/28/02) and 1,104 persons were interviewed for the T(1) poll (03/18/08-04/05/08).


RESULTS
While in 2002 a proportion of 31.9% of the interviewed persons knew not a single correct stroke symptom, in 2008 this portion amounted to 27.3%. Three or more correct signs were mentioned by 18.6% in the T0 survey versus 25.5% in 2008 (T(1) survey). Symptoms which were mentioned significantly more frequently in 2008 than in 2002 were hemiplegia and dropping corner of the mouth (+5.3%), respectively, numbness/paresthesia (+17.9%), trouble speaking or understanding (+6.1%), and trouble seeing/visual impairment (+4.3%). When being asked: "What would you do in case of stroke?", 69% of the answers in 2008 were correct (call emergency number 112). There were no significant differences in knowledge of risk factors. About 25% of participants in 2008 stated, that they remembered the stroke awareness campaign or related events.


CONCLUSIONS
The present study shows a moderate improvement of community knowledge about stroke with respect to symptoms and proper action in the course of the 5 years' public-health intervention. In comparison to similar surveys performed in 2000 and 2004, especially knowledge of correct action in case of emergency (stroke = medical emergency = call 112) improved. Still, there are persisting gaps in knowledge about stroke in the community, which make further efforts of improving this knowledge recommendable.
Rau
Rüdiger
R
Kreis Wesel, Fachbereich Gesundheitswesen, Geschäftsstelle der Kommunalen Gesundheitskonferenz (KGK), Moers, Germany. ruediger.rau@kreis-wesel.de
Mensing
Monika
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D004632:Emergency Medical Services; D005260:Female; D005858:Germany; D006266:Health Education / Q000639:trends*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000639:trends*; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D011634:Public Health / Q000639:trends*; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D055815:Young Adult