Abstract P122: An Interactive Intervention to Increase Stroke Knowledge: Results of the SWIFT Study
Introduction: The majority of acute stroke patients do not seek care within the optimal 3 hour time frame. General informational strategies have not increased stroke preparedness, possibly due to a lack of attention to health literacy or cultural tailoring. Several interventions have successfully increased stroke knowledge yet there remains skepticism that knowledge alone can lead to behavior change. The Stroke Warning Information and Faster Treatment (SWIFT) trial is the first intervention to rigorously test whether an interactive educational intervention (II; 2 in-hospital educational sessions and health literate, culturally tailored materials), compared to an enhanced educational intervention (EE; only educational materials) can increase arrival times for stroke/TIA recurrence to the emergency department (ED) in 1193 participants.
Aims: SWIFT found large, non-differential increases in the proportion of participants arriving to the ED within 3 hours in both the II and EE group. Here we assess the effect of SWIFT on stroke knowledge (SK), and stroke preparedness (SP), and assess differences by race.
Methods: SK was assessed with the 29 item stroke knowledge scale and dichotomized as high/low SK (≥ 23/< 23 correct). SP was dichotomized into those that knew the three important things to tell a health professional after the onset of stroke symptoms and those that identified less than 3 things. These scales were measured at baseline, and one and twelve months after baseline. We fit logit-linear models for high SK and high SP using generalized estimating equations.
Results: We observed no difference between groups at baseline in SK (p-value = 0.44) or SP (p-value = 0.36). For SK, we observed statistically significant effect modification such that knowledge increased over time (p-value = 0.02) and the effect was differential by intervention group (p-value = 0.04). At one month the II group had 1.63 (95%CI = 1.23, 2.15) times greater odds of having high SK compared to the EE group but by twelve months there was no difference between groups (OR=1.21; 0.87, 1.67). However, for SP there is not a statistically significant effect of time (p-value = 0.07) but there is a difference in the rate of change by group. The II group had greater odds of having high SP at one month (OR=3.36; 1.86, 6.10) and twelve months (OR=7.64; 2.49, 23.49) compared to the EE group. We did not observe differences in rates of change by race for SK (p-value = 0.21) or SP (p-value = 0.86) but SK (p-value < 0.01) and SP (p-value < 0.01) increased over time for all races. Overall, we find that both II and EE increase SK over 12 months but that only II was able to increase SP. Moreover, this effect was observed for all race ethnic groups.
Conclusions: The provision of culturally tailored, health literate information alone was able to increase SK; it did not eliminate racial disparities in SK but did improve SK for all race/ethnic groups studied.
Author Disclosures: E.T. Roberts: None. E.K.T. Benn: None. L. Quarles: None. V. Perez: None. B. Boden-Albala: None.
- © 2014 by American Heart Association, Inc.