We conducted a survey of residents of nine communities of Jinjiang District, Chengdu, from February 2017 to February 2019 (including Chunxi, Yanshikou, Niushikou, Hongsha, Jinjiang, Lianxin, Wanke, Quan subtree, Daci temple). According to the method of estimating the minimum sample size of qualitative data recommended by Chinese Residents of Nutrition and Health Survey in 2002, 1800 households in Jinjiang District, the center of Chengdu with a permanent population of 690,400, were randomly selected. A cluster sampling method was adopted, with sampling of 200 households in each community according to the residence number. The participants were permanent residents of the community (The inclusion criteria were aged ≥ 18; household registration was required to be considered a local, and the residents should have lived in the locality for more than 2 years).
Using an epidemiological investigation, combined with the literature reports from China and abroad[1-3,5-8,12], a questionnaire on stroke-related knowledge was designed to conduct a cluster sampling survey among nine community residents in Jinjiang District, Chengdu. The questionnaire had 21 questions, which contained 4 main sections:
(1) Respondents’ demographic details such as sex, age, ethnicity, educational level, monthly household income, and health insurance.
(2) Respondents’ understanding of stroke risk factors (including high blood pressure, hyperlipidemia, diabetes, heart disease, drinking, smoking, stroke, obesity, age, genetic factors, atherosclerosis, vascular stenosis, lack of exercise, blood viscosity and etc).
(3) Respondents’ recognition of stroke warning signs [5 “Suddens,” including (i) sudden difficulty in speaking, understanding, or slurred speech, (ii) sudden blurred vision in one or both eyes, (iii) sudden severe headache with unknown cause, (iv) sudden dizziness, difficulty in walking, loss of balance or co-ordination, and (v) sudden numbness or weakness of the face and/or limb(s) on one side of the body]. The method of rapid identification of stroke involves applying the acronym “FAST” which means numbness or weakness on one side of the Face, numbness or weakness in the Arm, Speech or understanding difficulties and Time to call).
(4) Respondents’ awareness of the first-aid system to sudden symptoms of stroke. Respondents were asked the questions: If you are sure that someone is having a stroke, what will your first reaction be? (i) drive to hospital, (ii) call for doctor, (iii) call for 120; (iv) call for family. We aimed to carry out stroke health education activities with the theme of “understanding stroke” and evaluate the effect. Stroke knowledge was publicized in a variety of ways, including: (1) designing and making short videos which neurologists explained the risk factors of stroke, its prevention and treatment, and the description of the main symptoms and signs of stroke. The session on the first aid after the onset of stroke emphasized the importance of making an emergency call (120, in China), and the harm of delayed treatment. Stroke survivors were also invited to talk about their personal experience.We used television, the Internet, WeChat, magazines, and other media channels for publicity. (2) We produced a pamphlet on stroke health education to be distributed to all families in the community, and produced posters of stroke-related knowledge to display in public places in the community. The duration of intensive stroke education activity was 1 year. All the participants received health information from all or some of the media mentioned. The media platforms contained the same health information. We provided information pamphlets to the participants and encouraged them to take the pamphlet home. The level of community stroke awareness was investigated before and after the activity, and the effect of intensive publicity was evaluated. The main evaluation indicators were the proportion of residents that accepted stroke-related knowledge due to the publicity, and the change of residents’ recognition of stroke-related knowledge (stroke risk factors, stroke symptoms and signs, stroke and the treatment of specific symptoms). Face-to-face interviews were conducted by uniformly trained investigators.
Data were collected via a questionnaire on community residents’ stroke-related knowledge. The contents mainly included: (1) the general data of the participants; (2) stroke-related knowledge before and after the intensive publicity: stroke risk factors, warning symptoms, treatment measures of sudden symptoms, determination of post-stroke treatment.
After sorting out the data processing and survey data, the data were entered into the EPIDATA database and then imported into SPSS version 20 (IBM Corp., Armonk, NY, USA) for statistical analysis. Descriptive statistical analysis was used to assess the general characteristics of respondents, identify stroke-related risk factors, identify warning symptoms of stroke, and cope with stroke warning symptoms. Chi-square test was used to analyze the general characteristics of residents before and after intensive education and the residents' knowledge of stroke-related knowledge before and after intensive education. P value less than 0.05 was regarded as statistically significant.