Ethnic Disparities in Stroke Recognition in Individuals with Prior Stroke

Ellis, Charles; Egede, Leonard E.

doi:10.1177/003335490812300413

Cited by 25 publications

(21 citation statements)

References 25 publications

(54 reference statements)

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“…10 The reasons for the high proportion of participants who identified cocaine use as a stroke risk factor are not clear, but may be related to high rates of use in this and surrounding communities and the high proportion of individuals who live below the poverty line. 11 Our results are in keeping with other analyses of the BRFSS data where Hispanics had lower overall stroke literacy, 6-8,12 though we did not collect data on household income or educational achievement to correct for these important covariates. The differences noted between Hispanics and African Americans are interesting given the similar burden of risk factors and stroke incidence in both groups at younger ages and reflect an important need to understand how to best educate these at-risk patients.…”

Section: Discussionsupporting

confidence: 81%

“…5 Analyses from the BRFSS in men and women from 2003 to 2005 have identified Hispanic ethnicity, being uninsured, earning less than $35,000 per year, and not completing high school as associated with poor stroke and heart disease literacy. [6][7][8] In our study we aimed to explore stroke literacy in Central Harlem, a predominantly African American (two-thirds of all residents) urban population with a high proportion of the population living under the federal poverty level (New York City Department of Health, 2000). We further aimed to delineate whether there were any differences based on race/ethnicity or gender.…”

mentioning

confidence: 99%

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Stroke literacy in Central Harlem

Willey¹,

Williams²,

Boden‐Albala³

2009

Neurology

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 99%

Stroke literacy in Central Harlem

Willey¹,

Williams²,

Boden‐Albala³

2009

Neurology

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“…Sixty-five percent of stroke patients seen in an inpatient rehabilitation facility stated they would call 9-1-1 if they thought they were having a stroke [35]. These findings were lower than reported by Ellis and Egede [15 ]in their examination of national data from the US Centers for Disease Control, who found that 83% of stroke survivors knew to call 9-1-1 as a first action in the event of having a stroke. Finally, overall knowledge of stroke was reported in 1 study by Sullivan and Waugh [36] based on data collected from survivors of TIA and stroke using the Stroke Knowledge Test (SKT) [37].…”

Section: Resultsmentioning

confidence: 98%

“…Because stroke survivors are at an increased risk of recurrent stroke, it is critical that they understand stroke symptoms and the need to seek urgent care in the event of experiencing such symptoms. Data suggest that knowledge of stroke symptoms may be low in both the general population and among stroke survivors [13,14,15,16,17]. Poor recognition of stroke symptoms has been attributed to delayed seeking of treatment.…”

Section: Introductionmentioning

confidence: 99%

Poststroke Knowledge and Symptom Awareness: A Global Issue for Secondary Stroke Prevention

Ellis¹,

Barley²,

Grubaugh

2013

Cerebrovasc Dis

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Background: Stroke survivors are at a substantial risk of repeat stroke. Despite this, many stroke survivors continue their unhealthy prestroke lifestyles.Lack of knowledge related to stroke and stroke risk has been proposed as one contributor to the continuance of unhealthy lifestyles. A comprehensive literature currently exists related to knowledge of stroke and its risk factors and recognition of stroke symptoms in the general population, but less is known about these issues among stroke survivors who are at a higher risk for stroke. The purpose of this review was to examine stroke knowledge among stroke survivors. Methods: Data sources were MEDLINE, CINAHL and the Cochrane Library, and the reference lists of published papers were searched to identify relevant studies. We extracted data related to stroke knowledge (general and risk factors) and symptom awareness from studies designed to examine stroke knowledge among stroke survivors. For the study design, we completed a systematic review of stroke knowledge (general information, stroke symptoms and risk factors) among stroke survivors. Standardized and nonstandardized measurements were taken of: (1) general stroke knowledge, i.e. cause, type (ischemic vs. hemorrhage), location, body parts affected and what action to take in the event of having a stroke, (2)stroke awareness (common warning signs and symptoms such as: weakness/numbness, confusion/difficulty speaking, difficulty seeing in one or both eyes, difficulty walking, headache of no known cause) and (3) knowledge or identification of common stroke risk factors (e.g. high blood pressure, high blood sugar,high cholesterol,obesityand smoking). Due to limited information on outcomes and the heterogeneity of the studies, a formal meta-analysis was not conducted. Instead, we completed a qualitative aggregation of study findings. Results: Data from 18 studies spanning 8 countries and including 8,147 participants met the inclusion criteria for this review. These studies offer evidence that many stroke survivors do not have a greater knowledge of stroke despite their having experienced such a life-changing event. Conclusions: Due to their limited knowledge, many stroke survivors may not engage in the required preventive behaviors for good health and reducing the risk of a stroke recurring. More specifically, stroke survivors may understand the cause of their stroke but not be able to identify many stroke symptoms or common stroke risk factors. Stroke education programs should be designed to improve stroke knowledge and facilitate the actions necessary for reducing stroke risk.

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“…100 Even among those with a history of prior stroke, the ability to recognize stroke symptoms and the need to activate emergency medical services remains poor, with lower performance among non-Hispanic blacks or African Americans (22.3%) and Hispanic/other group members (16.7%) than among whites (28.9%). 101 Hispanic ethnicity remained an independent predictor of lack of awareness in multivariate models. These data indicate that all groups, but particularly minority populations, fall short of the 83% rate of stroke symptom recognition targeted by Healthy People 2010.…”

Section: Differences In Disease Awarenessmentioning

confidence: 93%

Racial-Ethnic Disparities in Stroke Care: The American Experience

Cruz‐Flores¹,

Rabinstein²,

Biller³

et al. 2011

Stroke

423

261

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Purpose-Our goal is to describe the effect of race and ethnicity on stroke epidemiology, personal beliefs, access to care, response to treatment, and participation in clinical research. In addition, we seek to determine the state of knowledge on the main factors that may explain disparities in stroke care, with the goal of identifying gaps in knowledge to guide future research. The intended audience includes physicians, nurses, other healthcare professionals, and policy makers. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council Scientific Statement Oversight Committee and represent different areas of expertise in relation to racial-ethnic disparities in stroke care. The writing group reviewed the relevant literature, with an emphasis on reports published since 1972. The statement was approved by the writing group; the statement underwent peer review, then was approved by the American Heart Association Science Advisory and Coordinating Committee. Results-There are limitations in the definitions of racial and ethnic categories currently in use. For the purpose of this statement, we used the racial categories defined by the US federal government: white, black or African American, Asian, American Indian/Alaskan Native, and Native Hawaiian/other Pacific Islander. There are 2 ethnic categories: people of Hispanic/Latino origin or not of Hispanic/Latino origin. There are differences in the distribution of the burden of risk factors, stroke incidence and prevalence, and stroke mortality among different racial and ethnic groups. In addition, there are disparities in stroke care between minority groups compared with whites. These disparities include lack of awareness of stroke symptoms and signs and lack of knowledge about the need for urgent treatment and the causal role of risk factors. There are also differences in attitudes, beliefs, and compliance among minorities compared with whites. Differences in socioeconomic status and insurance coverage, mistrust of the healthcare system, the relatively limitedThe findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on April 6, 2011. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@woltersklu...

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Ethnic Disparities in Stroke Recognition in Individuals with Prior Stroke

Cited by 25 publications

References 25 publications

Stroke literacy in Central Harlem

Stroke literacy in Central Harlem

Poststroke Knowledge and Symptom Awareness: A Global Issue for Secondary Stroke Prevention

Racial-Ethnic Disparities in Stroke Care: The American Experience

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