title: Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers.
abstract: Many factors influence pre-hospital delays in the event of stroke. This study aimed to develop and evaluate a comprehensive educational program for decreasing pre-hospital delays in high-risk stroke population.
  
  
  
  We enrolled 220 high-risk stroke population and caregivers from six urban communities in Harbin from May 2013 to May 2015, and randomly divided them into intervention and control groups. We implemented a comprehensive educational program (intervention group), comprising public lectures, instructional brochures, case videos, simulations, and role-playing from May 2013 to May 2015. We delivered conventional oral education in the control group. We compared stroke pre-hospital delay behavioral intention (SPDBI), pre-hospital stroke symptom coping test (PSSCT), and stroke pre-symptoms alert test (SPSAT) results between the groups before and 6, 12, and 18 months after health intervention.
  
  
  
  There were significant differences between before and after intervention (P < 0.01). SPDBI, PSSCT, and SPSAT scores were significantly different between the groups (P < 0.01). The interaction between time and intervention method was significant (P < 0.01). According to multivariate repeated measures analysis of variance, SPDBI, PSSCT, and SPSAT scores were significantly different at each time after intervention (P < 0.05).
  
  
  
  The comprehensive educational program was significantly effective in decreasing SPDBI, improving knowledge, enhancing stroke pre-symptoms alert, and reducing the possibility of pre-hospital delays.
authors.affiliation: School of Nursing, Harbin Medical University, 246 Xuefu Road, Harbin, 150086, Heilongjiang Province, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: School of Nursing, Harbin Medical University, 246 Xuefu Road, Harbin, 150086, Heilongjiang Province, People's Republic of China. zhaoqiuli1957@163.com.
authors.forename: Qiuli
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: School of Nursing, Harbin Medical University, 246 Xuefu Road, Harbin, 150086, Heilongjiang Province, People's Republic of China.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Zhu
authors.affiliation: School of Nursing, Harbin Medical University, 246 Xuefu Road, Harbin, 150086, Heilongjiang Province, People's Republic of China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Neurology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang Province, People's Republic of China.
authors.forename: Yulan
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: School of Nursing, Harbin Medical University, 246 Xuefu Road, Harbin, 150086, Heilongjiang Province, People's Republic of China.
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
authors.affiliation: School of Nursing, Harbin Medical University, 246 Xuefu Road, Harbin, 150086, Heilongjiang Province, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: School of Nursing, Harbin Medical University, 246 Xuefu Road, Harbin, 150086, Heilongjiang Province, People's Republic of China.
authors.forename: Minghui
authors.initials: M
authors.lastname: Li
mesh_terms: D017028:Caregivers; D005260:Female; D006266:Health Education / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D020521:Stroke / Q000453:epidemiology / Q000628:therapy*
keywords: Health education; High-risk stroke population; Pre-hospital delay; Stroke