title: Systematic review of mass media interventions designed to improve public recognition of stroke symptoms, emergency response and early treatment.
abstract: BACKGROUND
  Mass media interventions have been implemented to improve emergency response to stroke given the emergence of effective acute treatments, but their impact is unclear.
  
  
  METHODS
  Systematic review of mass media interventions aimed at improving emergency response to stroke, with narrative synthesis and review of intervention development.
  
  
  RESULTS
  Ten studies were included (six targeted the public, four both public and professionals) published between 1992 and 2010. Only three were controlled before and after studies, and only one had reported how the intervention was developed. Campaigns aimed only at the public reported significant increase in awareness of symptoms/signs, but little impact on awareness of need for emergency response. Of the two controlled before and after studies, one reported no impact on those over 65 years, the age group at increased risk of stroke and most likely to witness a stroke, and the other found a significant increase in awareness of two or more warning signs of stroke in the same group post-intervention. One campaign targeted at public and professionals did not reduce time to presentation at hospital to within two hours, but increased and sustained thrombolysis rates. This suggests the campaign had a primary impact on professionals and improved the way that services for stroke were organised.
  
  
  CONCLUSIONS
  Campaigns aimed at the public may raise awareness of symptoms/signs of stroke, but have limited impact on behaviour. Campaigns aimed at both public and professionals may have more impact on professionals than the public. New campaigns should follow the principles of good design and be robustly evaluated.
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Jan
authors.initials: J
authors.lastname: Lecouturier
authors.forename: Helen
authors.initials: H
authors.lastname: Rodgers
authors.forename: Madeleine J
authors.initials: MJ
authors.lastname: Murtagh
authors.forename: Martin
authors.initials: M
authors.lastname: White
authors.forename: Gary A
authors.initials: GA
authors.lastname: Ford
authors.forename: Richard G
authors.initials: RG
authors.lastname: Thomson
mesh_terms: D000368:Aged; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008402:Mass Media; D008875:Middle Aged; D011634:Public Health; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D015912:Thrombolytic Therapy; D013997:Time Factors