Stroke literacy in Central Harlem: a high-risk stroke population.
BACKGROUND
Awareness of stroke warning symptoms and risk factors (stroke literacy), as well as knowledge of available treatment options, may be poor in high-risk populations. We sought to evaluate stroke literacy among residents of Central Harlem, a predominantly African American population, in a cross-sectional study.


METHODS
Ten community-based sites in Central Harlem were identified between 2005 and 2006 for administration of a stroke knowledge survey. Trained volunteers administered in-person closed-ended questionnaires focused on stroke symptoms and risk factors.


RESULTS
A total of 1,023 respondents completed the survey. African Americans comprised 65.7% (n = 672) of the survey cohort. The brain was correctly identified as the site where a stroke occurs by 53.7% of respondents, whereas the heart was incorrectly identified by 20.8%. Chest pain was identified as a symptom of stroke by 39.7%. In multivariable analyses, African Americans (odds ratio [OR] 2.20, 95% confidence interval [CI] 1.09-4.45) and Hispanics (OR 5.27, 95% CI 2.46-11.30) were less likely to identify the brain as the damaged organ in stroke. Hispanics were more likely to incorrectly identify chest pain as a stroke symptom, compared with whites (OR 3.40, 95% CI 1.49-7.77). No associations were found between calling 911 and race/ethnicity and stroke knowledge, although women were more likely than men to call 911 (OR 0.50, 95% CI 0.30-0.80).


CONCLUSIONS
Significant deficiencies in stroke literacy exist in this high-risk population, especially when compared with national means. Culturally tailored and sustainable educational campaigns should be tested in high-risk populations as part of stroke public health initiatives.
Willey
Joshua Z
JZ
Department of Neurology, Columbia University, New York, NY, USA. jzw2@columbia.edu
Williams
Olajide
O
Boden-Albala
Bernadette
B
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000208:ethnology; D010353:Patient Education as Topic / Q000379:methods; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology* / Q000517:prevention & control; D055815:Young Adult