title: Cooperative strategies to develop effective stroke and heart attack awareness messages in rural american Indian communities, 2009-2010.
abstract: BACKGROUND
  National initiatives to improve the recognition of heart attack and stroke warning signs have encouraged symptomatic people to seek early treatment, but few have shown significant effects in rural American Indian (AI) communities.
  
  
  METHODS
  During 2009 and 2010, the Montana Cardiovascular Health Program, in collaboration with 2 tribal health departments, developed and conducted culturally specific public awareness campaigns for signs and symptoms of heart attack and stroke via local media. Telephone surveys were conducted before and after each campaign to evaluate the effectiveness of the campaigns.
  
  
  RESULTS
  Knowledge of 3 or more heart attack warning signs and symptoms increased significantly on 1 reservation from 35% at baseline to 47% postcampaign. On the second reservation, recognition of 2 or more stroke signs and symptoms increased from 62% at baseline to 75% postcampaign, and the level of awareness remained at 73% approximately 4 months after the high-intensity campaign advertisements ended. Intent to call 9-1-1 did not increase in the heart attack campaign but did improve in the stroke campaign for specific symptoms. Recall of media campaigns on both reservations increased significantly from baseline to postcampaign for both media outlets (ie, radio and newspaper).
  
  
  CONCLUSIONS
  Carefully designed, culturally specific campaigns may help eliminate disparities in the recognition of heart attack and stroke warning signs in AI communities.
authors.affiliation: Montana Cardiovascular Health Program, Montana Department of Public Health and Human Services, Helena, MT 59620-2951, USA. coser@mt.gov
authors.forename: Carrie S
authors.initials: CS
authors.lastname: Oser
authors.forename: Dorothy
authors.initials: D
authors.lastname: Gohdes
authors.forename: Crystelle C
authors.initials: CC
authors.lastname: Fogle
authors.forename: Fawn
authors.initials: F
authors.lastname: Tadios
authors.forename: Velva
authors.initials: V
authors.lastname: Doore
authors.forename: Doreen S
authors.initials: DS
authors.lastname: Bell
authors.forename: Todd S
authors.initials: TS
authors.lastname: Harwell
authors.forename: Steven D
authors.initials: SD
authors.lastname: Helgerson
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D003299:Cooperative Behavior; D004502:Education, Medical, Continuing; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006293:Health Promotion / Q000379:methods*; D054625:Healthcare Disparities / Q000592:standards; D006801:Humans; D007198:Indians, North American / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009009:Montana / Q000453:epidemiology; D016730:Program Development; D015397:Program Evaluation; D012959:Socioeconomic Factors; D020521:Stroke / Q000517:prevention & control / Q000523:psychology*