title: Community-based participatory research: a new approach to engaging community members to rapidly call 911 for stroke.
abstract: OBJECTIVE
  Acute stroke treatments are underutilized primarily because of delayed hospital arrival. Using a community-based participatory research approach, we explored stroke self-efficacy, knowledge, and perceptions of stroke among a predominately African American population in Flint, Michigan.
  
  
  METHODS
  In March 2010, a survey was administered to youth and adults after religious services at 3 churches and during 1 church health day. The survey consisted of vignettes (12 stroke, 4 nonstroke) to assess knowledge of stroke warning signs and behavioral intent to call 911. The survey also assessed stroke self-efficacy, personal knowledge of someone who had experienced a stroke, personal history of stroke, and barriers to calling 911. Linear regression models explored the association of stroke self-efficacy with behavioral intent to call 911 among adults.
  
  
  RESULTS
  Two hundred forty-two adults and 90 youths completed the survey. Ninety-two percent of adults and 90% of youth respondents were African American. Responding to 12 stroke vignettes, adults would call 911 in 72% (SD, 0.26) of the vignettes, whereas youths would call 911 in 54% of vignettes (SD, 0.29; P<0.001). Adults correctly identified stroke in 51% (SD, 0.32) of the stroke vignettes and youth correctly identified stroke in 46% (SD, 0.28) of the stroke vignettes (P=0.28). Stroke self-efficacy predicted behavioral intent to call 911 (P=0.046).
  
  
  CONCLUSIONS
  In addition to knowledge of stroke warning signs, behavioral interventions to increase both stroke self-efficacy and behavioral intent may be useful for helping people make appropriate 911 calls for stroke. A community-based participatory research approach may be effective in reducing stroke disparities.
authors: Stroke Program, University of Michigan Medical School, Ann Arbor, MI 48109, USA. lerusche@umich.edu
authors: Lesli E
authors: LE
authors: Skolarus
authors: Marc A
authors: MA
authors: Zimmerman
authors: Jillian
authors: J
authors: Murphy
authors: Devin L
authors: DL
authors: Brown
authors: Kevin A
authors: KA
authors: Kerber
authors: Sarah
authors: S
authors: Bailey
authors: Sophronia
authors: S
authors: Fowlkes
authors: Lewis B
authors: LB
authors: Morgenstern
references: Stroke. 2000 Nov;31(11):2591-6
references: 11062280
references: Cognit Ther Res. 1983;7(5):379-88
references: 12265688
references: J Prim Prev. 2010 Apr;31(1-2):31-9
references: 20127281
references: Psychol Rev. 1977 Mar;84(2):191-215
references: 847061
references: JAMA. 2001 May 23-30;285(20):2643-8
references: 11368741
references: Neurology. 2009 Dec 8;73(23):1950-6
references: 19890071
references: Stroke. 2005 May;36(5):1035-9
references: 15817898
references: Stroke. 2008 Aug;39(8):2331-5
references: 18566304
references: Annu Rev Public Health. 1998;19:173-202
references: 9611617
references: Med Care. 2001 Nov;39(11):1217-23
references: 11606875
references: Public Health. 2001 Jan;115(1):54-61
references: 11402353
references: Health Educ Q. 1986 Spring;13(1):73-92
references: 3957687
references: Stroke. 2008 Oct;39(10):2809-16
references: 18635851
references: Med Care. 1999 Sep;37(9):957-63
references: 10493473
references: AIDS Care. 2000 Jun;12(3):255-66
references: 10928201
references: Soc Sci Med. 1997 Jan;44(2):231-40
references: 9015875
references: MMWR Morb Mortal Wkly Rep. 2007 May 18;56(19):474-8
references: 17510611
references: Arch Pediatr Adolesc Med. 2009 Feb;163(2):108-14
references: 19188641
references: Patient Educ Couns. 2000 Apr;40(1):67-82
references: 10705066
references: JAMA. 2005 May 18;293(19):2391-402
references: 15900010
references: Diabetes Care. 1995 Jul;18(7):943-9
references: 7555554
references: Stroke. 2007 Nov;38(11):2972-8
references: 17885255
references: Stroke. 2004 Feb;35(2):e27-9
references: 14739423
references: Stroke. 2007 Oct;38(10):2864-8
references: 17761926
references: Stroke. 1997 May;28(5):912-5
references: 9158624
references: Stroke. 2009 Jul;40(7):2502-6
references: 19498187
references: Circulation. 2010 Apr 6;121(13):1492-501
references: 20308617
references: Am J Public Health. 1994 Dec;84(12):1918-22
references: 7998630
references: Psychol Addict Behav. 2009 Mar;23(1):56-66
references: 19290690
references: Stroke. 2000 Aug;31(8):1925-8
references: 10926958
references: Ann Emerg Med. 2007 Aug;50(2):99-107
references: 17478010