title: Effects of intensive and moderate public education on knowledge of early stroke symptoms among a Japanese population: the Acquisition of Stroke Knowledge study.
abstract: OBJECTIVE
  To assess the effects of intensive and moderate public education on knowledge of early stroke symptoms among a general Japanese population.
  
  
  METHODS
  Information on early stroke symptoms was distributed by leaflet 12× and by booklet twice in an intensive intervention area >22 months, and by leaflet and booklet once each in a moderate intervention area. No distribution occurred in the control area. Before and after the intervention, a mailed survey was conducted in the 3 areas. A total of 2734 individuals, aged 40 to 74 years, who did not select all 5 correct symptoms of stroke in the preintervention survey were eligible for our analysis.
  
  
  RESULTS
  The numbers of correct answers selected about stroke symptoms did not differ significantly among the 3 areas in the preintervention survey (P=0.156). In the postintervention survey, the proportions of participants who selected sudden 1-sided numbness or weakness (94.2% in the intensive intervention area, 88.3% in the moderate intervention area, and 89.2% in the control area; P<0.001) and sudden severe headache (76.8%, 70.1%, and 70.4%, respectively; P<0.001) differed significantly among the 3 areas. After adjustment for confounding factors, the multivariable-adjusted odds ratios (95% confidence intervals) for correctly choosing all 5 symptoms were 1.35 (1.07-1.71) in the intensive intervention area and 0.96 (0.74-1.24) in the moderate intervention area compared with the control area.
  
  
  CONCLUSIONS
  Our findings suggest that frequent distribution of leaflets and booklets significantly improved the short-term knowledge of community residents about early symptoms of stroke.
authors.affiliation: From the Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan (A.M., N.M.); Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan (T.O.); Japan Stroke Association, Osaka, Japan (H.N., T.Y.); Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (K.T.); Department of Epidemiology, Research Institute for Brain and Blood Vessels, Akita, Japan (K.S.); Rehabilitation Center, Chugoku Rosai Hospital, Hiroshima, Japan (A.T.); Department of Neurology, Shizuoka City Shimizu Hospital, Shizuoka, Japan (T.H.); and National Cerebral and Cardiovascular Center, Osaka, Japan (T.Y.).
authors.forename: Akiko
authors.initials: A
authors.lastname: Morimoto
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: Takenori
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D020521:Stroke; D063189:Symptom Assessment
keywords: early stroke symptoms; knowledge; leaflet/booklet distribution; public education