title: Effects of a Public Education Campaign on the Association Between Knowledge of Early Stroke Symptoms and Intention to Call an Ambulance at Stroke Onset: The Acquisition of Stroke Knowledge (ASK) Study.
abstract: BACKGROUND
  An immediate ambulance call offers the greatest opportunity for acute stroke therapy. Effectively using ambulance services requires strengthening the association between knowledge of early stroke symptoms and intention to call an ambulance at stroke onset, and encouraging the public to use ambulance services.
  
  
  METHODS
  The present study utilized data from the Acquisition of Stroke Knowledge (ASK) study, which administered multiple-choice, mail-in surveys regarding awareness of early stroke symptoms and response to a stroke attack before and after a 2-year stroke education campaign in two areas subject to intensive and moderate intervention, as well as in a control area, in Japan. In these three areas, 3833 individuals (1680, 1088 and 1065 participants in intensive intervention, moderate intervention, and control areas, respectively), aged 40 to 74 years, who responded appropriately to each survey were included in the present study.
  
  
  RESULTS
  After the intervention, the number of correctly identified symptoms significantly associated with intention to call an ambulance (P < 0.05) increased (eg, from 4 to 5 correctly identified symptoms), without increasing choice of decoy symptoms in the intensive intervention area. Meanwhile, in other areas, rate of identification of not only correct symptoms but also decoy symptoms associated with intention to call an ambulance increased. Furthermore, the association between improvement in the knowledge of stroke symptoms and intention to call an ambulance was observed only in the intensive intervention area (P = 0.009).
  
  
  CONCLUSIONS
  Our results indicate that intensive interventions are useful for strengthening the association between correct knowledge of early stroke symptoms and intention to call an ambulance, without strengthening the association between incorrect knowledge and intention to call an ambulance.
authors.affiliation: Department of Health Science, Kyoto Koka Women's University.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nakayama
authors.forename: Naomi
authors.initials: N
authors.lastname: Miyamatsu
authors.forename: Akiko
authors.initials: A
authors.lastname: Morimoto
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; D000552:Ambulances / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D007564:Japan; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D020521:Stroke / Q000175:diagnosis* / Q000523:psychology*