title: Individual and community determinants of calling 911 for stroke among African Americans in an urban community.
abstract: BACKGROUND
  African Americans receive acute stroke treatment less often than non-Hispanic whites. Interventions to increase stroke preparedness (recognizing stroke warning signs and calling 911) may decrease the devastating effects of stroke by allowing more patients to be candidates for acute stroke therapy. In preparation for such an intervention, we used a community-based participatory research approach to conduct a qualitative study exploring perceptions of emergency medical care and stroke among urban African American youth and adults.
  
  
  RESULTS
  Community partners, church health teams, and church leaders identified and recruited focus group participants from 3 black churches in Flint, MI. We conducted 5 youth (11-16 years) and 4 adult focus groups from November 2011 to March 2012. A content analysis approach was taken for analysis. Thirty-nine youth and 38 adults participated. Women comprised 64% of youth and 90% of adult focus group participants. All participants were black. Three themes emerged from the adult and youth data: (1) recognition that stroke is a medical emergency; (2) perceptions of difficulties within the medical system in an under-resourced community, and; (3) need for greater stroke education in the community.
  
  
  CONCLUSIONS
  Black adults and youth have a strong interest in stroke preparedness. Designs of behavioral interventions to increase stroke preparedness should be sensitive to both individual and community factors contributing to the likelihood of seeking emergency care for stroke.
authors.affiliation: Stroke Program, University of Michigan Medical School, Ann Arbor, MI 48109, USA. lerusche@umich.edu
authors.forename: Lesli E
authors.initials: LE
authors.lastname: Skolarus
authors.forename: Jillian B
authors.initials: JB
authors.lastname: Murphy
authors.forename: Marc A
authors.initials: MA
authors.lastname: Zimmerman
authors.forename: Sarah
authors.initials: S
authors.lastname: Bailey
authors.forename: Sophronia
authors.initials: S
authors.lastname: Fowlkes
authors.forename: Devin L
authors.initials: DL
authors.lastname: Brown
authors.forename: Lynda D
authors.initials: LD
authors.lastname: Lisabeth
authors.forename: Emily
authors.initials: E
authors.lastname: Greenberg
authors.forename: Lewis B
authors.initials: LB
authors.lastname: Morgenstern
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D002648:Child; D055812:Community-Based Participatory Research; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006293:Health Promotion; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010353:Patient Education as Topic; D010465:Perception; D013689:Telephone / Q000706:statistics & numerical data*; D019037:Urban Health Services / Q000706:statistics & numerical data*
keywords: blacks; emergency; stroke