Mensing. Community stroke knowledge: a new information strategy using a joint project of the public health service and the hairdressers' guild of the Wesel district. Journal of Public Health, Springer Verlag, 2009, 17 (6) Abstract Objectives The public health programme "Healthy Lower Rhine…against Stroke" is aimed at improving the population's knowledge about stroke and thus at reducing the prehospital phase in patients with suspected stroke. First evaluation results indicate that apart from providing information through the mass media, there is an urgent need to further develop the face-to-face communication approach. This has to be achieved by efficient but also effective means, given that financial and personnel resources are scarce. Study design In cooperation with lögd Bielefeld, the Lower Health Authority of the Wesel District (health department) developed a postcard-sized quiz card containing exclusively correct answers on the issue of stroke, risk factors as well as symptom and action knowledge. For face-to-face communication, the hairdressers could be convinced to be included in the project. The hairdressers posed the corresponding questions and marked those answers of the clients that were identical with the quiz card answers with a cross. Answers not given by the clients were read out loud to them by the hairdressers, who were thus "styling up" the knowledge of their clients. To increase participation in the project, prizes were offered for the hairdressers with the most filled-in quiz cards as well as for three of the participating clients (drawing of prizes 1-3). More than 380 hairdressers in the Wesel district were sent a letter inviting them to participate as facilitators in this project, which is probably the first of its kind worldwide. Methods The machine-readable quiz cards were collected and statistically evaluated including data regarding age and gender of the participants. Results were to be presented in the form of a descriptive statistic. Results Thirty-three hairdressers from 12 cities and municipalities of the Wesel district participated in this joint action of the Wesel district Department of Health and the Wesel hairdressers' guild, dealing with the monitoring and imparting of basic knowledge on the issue of stroke. Almost 2,000 clients were interviewed by the participating hairdressers, and knowledge gaps were closed by information read out to them. Discussion This innovative approach of imparting knowledge can be regarded as the model of an effective and economical way of communicating health information to the broader public.
Community knowledge of stroke signs and risk factors in Germany is poor, while lacking knowledge is an important cause for delays in hospital admission. In the Wesel district (North Rhine-Westphalia) the local health conference put this issue on its agenda and initiated a phone survey. The aim was to assess community knowledge of stroke symptoms and risk factors as well as self-reported prevalence of established risk factors; in addition, the role of information on stroke risk provided to patients by the general practitioner (GP) was to be estimated. The study population was defined as comprising all residents in the district of Wesel between 18 and 87 years of age (approx. 385,000 people). The sample of 1,089 persons was drawn randomly and the telephone survey was carried out by the CATI-Laboratory (Computer Assisted Telephone Interviews) at the Institute of Public Health (lögd, Bielefeld) between 18 February and 28 March 2002. A total of 1,089 people were interviewed, of whom 31.9% knew no symptom, 25.7% could name one symptom, 23.8% two symptoms and 18.6% knew three or more correct signs. Weakness/paralysis was named most frequently by 43.6% of the respondents. The majority of respondents named smoking as a risk factor (59.6%), while hypertension was mentioned by 39.4% of the participants. Among 555 respondents aged 45 years and older, 75.1% said they had never received a GP's advice on stroke risk, while 75.3% among these persons reported to have at least one risk factor. The present study shows a persistent lack of community knowledge about stroke. It is recommended that knowledge be improved especially with regard to (a) proper action: "stroke is a medical emergency-call the emergency telephone code 112", (b) symptoms and warning signs and (c) major stroke risk factors, especially high blood pressure. Moreover, information and advice on stroke should play a bigger part in the doctor's daily practice; patients should be made aware of their stroke risks and ways of prevention.
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