title: Public awareness of early symptoms of stroke and information sources about stroke among the general Japanese population: the Acquisition of Stroke Knowledge Study.
abstract: BACKGROUND
  It is important that the general population be aware of the early symptoms, since it has been shown that early arrival to hospitals leads better prognosis of stroke patients. However, the general population is not well informed about the early symptoms of stroke. This study was conducted to clarify which stroke symptoms are less well known and which information sources are related to awareness of stroke symptoms.
  
  
  METHODS
  A multiple-choice, mail-in survey involving 5,540 randomly selected residents, aged 40-74 years, of 3 cities in Japan was conducted. Their knowledge about stroke symptoms and their information sources were surveyed; information sources were classified as mass media (television/newspaper/radio) and personal communication sources (posters/leaflets/internet/health professionals/family and/or friends). 'Awareness' was defined as selecting all 5 of the correct stroke symptoms from among 10 listed symptoms with decoy choices. The estimated fraction of the possible impact due to each source on the whole population was also calculated by odds ratios (ORs) and the proportion of respondents who selected each source (Pe). The combined effects of mass media and personal communication sources on awareness were also assessed.
  
  
  RESULTS
  Of the 5,540 residents, only 23% selected all 5 correct symptoms. Visual disturbance was the least known of the 5 symptoms (35%). All sources were positively related to awareness, with ORs (Pe) of: television, 1.58 (72.5%); newspaper, 1.79 (48.0%); radio, 1.74 (13.3%); posters, 1.73 (7.6%); leaflets, 1.50 (24.7%); Internet, 1.66 (5.6%); health professionals, 1.33 (34.8%), and family/friends, 1.21 (44.6%). The estimated fraction of the possible impact due to each source was higher for mass media (television, 0.31 and newspaper, 0.28) than personal communication sources (Internet, 0.04 and leaflets, 0.12). Mass media only and mass media/personal communication sources were significantly associated (ORs: 1.66, 2.75, respectively).
  
  
  CONCLUSIONS
  As a single method of public education, television could be the most effective strategy. Moreover, the combined approach involving mass media and personal communication sources might have a synergistic effect. Less well-known symptoms, such as visual disturbances, should be noted in public education campaigns.
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Japan. miyan@belle.shiga-med.ac.jp
authors.forename: Naomi
authors.initials: N
authors.lastname: Miyamatsu
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nakayama
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
authors.forename: Kazuo
authors.initials: K
authors.lastname: Suzuki
authors.forename: Akihiro
authors.initials: A
authors.lastname: Toyota
authors.forename: Takashi
authors.initials: T
authors.lastname: Hata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hozawa
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Akiko
authors.initials: A
authors.lastname: Morimoto
authors.forename: Mihoko
authors.initials: M
authors.lastname: Ogita
authors.forename: Ayumi
authors.initials: A
authors.lastname: Morino
authors.forename: Takenori
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan; D008297:Male; D008402:Mass Media; D008875:Middle Aged; D020521:Stroke / Q000175:diagnosis*; D011795:Surveys and Questionnaires