[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.
Kreis Wesel, Fachbereich Gesundheitswesen, Geschäftsstelle der Kommunalen Gesundheitskonferenz (KGK), Moers, Germany. ruediger.rau@kreis-wesel.de
Rüdiger
R
Rau
Monika
M
Mensing
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