title: Educational outreach to improve emergency medical services systems of care for stroke in Montana.
abstract: OBJECTIVE
  To improve stroke knowledge, identification, and acute care among first responders (FRs) and emergency medical technicians (EMTs) through educational outreach and support.
  
  
  METHODS
  Beginning in 2006, the Montana Stroke Initiative implemented outreach to FRs and EMTs and emergency medical services (EMS) statewide. Cross-sectional telephone surveys of FRs and EMTs were used to evaluate changes in stroke knowledge and practice in 2006 (n = 988) and 2009 (n = 944), overall and in rural and urban counties.
  
  
  RESULTS
  The respondents to the 2009 survey were more likely to report the availability of a stroke protocol in their service (69% vs. 61%, p = 0.001), training in the use of a stroke screening tool (62% vs. 42%, p < 0.001), use of a stroke screening tool (62% vs. 40%, p < 0.001), and an adequate level of knowledge about stroke (81% vs. 66%, p < 0.001) compared with the respondents to the 2006 survey. Significant improvements in each of these areas were achieved for both rural and urban FRs and EMTs.
  
  
  CONCLUSIONS
  Educational outreach to FRs and EMTs was associated with marked improvement in selected components of the EMS system of stroke care.
authors.affiliation: Cardiovascular Health Program, Chronic Disease Prevention and Health Promotion Bureau, Montana Department of Public Health and Human Services, and Montana Stroke Initiative, Helena, Montana 59620-2951, USA.
authors.forename: Carrie S
authors.initials: CS
authors.lastname: Oser
authors.forename: Michael J
authors.initials: MJ
authors.lastname: McNamara
authors.forename: Crystelle C
authors.initials: CC
authors.lastname: Fogle
authors.forename: Dorothy
authors.initials: D
authors.lastname: Gohdes
authors.forename: Steven D
authors.initials: SD
authors.lastname: Helgerson
authors.forename: Todd S
authors.initials: TS
authors.lastname: Harwell
mesh_terms: D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000592:standards*; D004634:Emergency Medical Technicians; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D009009:Montana; D011785:Quality Assurance, Health Care; D020521:Stroke / Q000628:therapy*