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Arthur M. Pancioli, MD; Joseph Broderick, MD; Rashmi Kothari, MD; Thomas Brott, MD; Alfred Tuchfarber, PhD; Rosie Miller, RN; Jane Khoury, MS; Edward Jauch, MD

JAMA. 1998;279:1288-1292.

Context.— Decreasing the time from stroke onset to hospital arrival and improving control of stroke risk factors depend on public knowledge of stroke warning signs and risk factors.

Objective.— To assess current public knowledge of stroke warning signs and risk factors.

Design.— A population-based telephone interview survey using random digit dialing conducted in 1995.

Setting.— The Greater Cincinnati, Ohio, metropolitan area, the population of which is similar to that of the United States overall in age, sex, percentage of blacks, and economic status.

Participants.— Respondents with age, race, and sex that matched the population of patients with acute stroke.

Main Outcome Measures.— Knowledge of risk factors for stroke and warning signs of stroke as defined by the National Institute of Neurological Disorders and Stroke.

Results.— Telephone calls were made to 17634 households, which yielded 2642 demographically eligible individuals. Interviews were completed by 1880 respondents (response rate, 71.2%). A total of 1066 respondents (57%) correctly listed at least 1 of the 5 established stroke warning signs, and of all respondents, 1274 (68%) correctly listed at least 1 of the established stroke risk factors. Of the respondents, 469 (57%) of 818 respondents with a history of hypertension listed hypertension, 142 (35%) of 402 respondents who were current smokers listed smoking, and 32 (13%) of 255 respondents with diabetes listed diabetes as a risk factor for stroke. Compared with those younger than 75 years, respondents 75 years or older were less likely to correctly list at least 1 stroke warning sign (60% vs 47%, respectively; P<.001) and were less likely to list at least 1 stroke risk factor (72% vs 56%, respectively; P<.001).

Conclusion.— Considerable education is needed to increase the public's awareness of the warning signs and risk factors for stroke. Respondents with self-reported risk factors for stroke are largely unaware of their increased risk. The population at greatest risk for stroke, the very elderly, are the least knowledgeable about stroke warning signs and risk factors.

From the Departments of Emergency Medicine (Drs Pancioli, Kothari, and Jauch), Neurology (Drs Broderick and Brott and Ms Miller), and Environmental Health (Ms Khoury), and the Institute for Policy Research (Dr Tuchfarber), University of Cincinnati, Cincinnati, Ohio.

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RELATED LETTER

Reducing Treatment Delay and Improving Diagnostic Accuracy for Patients With Acute Stroke
Daniel Mines, Steven Rosenzweig, Justiniano F. Campa, Jonathan L. Stolz, Lombardo F. Palma, Antonio Villa, Marzia Bonacina, Sabina Paese, Ezio Omboni, David L. Schriger, Mary Kalafut, Sidney Starkman, Michelle Krueger, Jeffrey L. Saver, Arthur M. Pancioli, Joseph Broderick, Rashmi Kothari, Thomas Brott, Alfred Tuchfarber, Rosie Miller, Jane Khoury, Edward Jauch, Phil B. Fontanarosa, and Margaret A. Winker
JAMA. 1999;281(1):31-34.
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