Development of an education campaign to reduce delays in pre-hospital response to stroke.
- Caminiti C Research and Innovation Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy. ccaminiti@ao.pr.it.
- Schulz P Institute of Communication and Health, Università della Svizzera italiana, Via Buffi 6, CH 6900, Lugano, Switzerland.
- Marcomini B Research and Innovation Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
- Iezzi E Research and Innovation Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
- Riva S Department of Oncology and Hematology, University of Milan, Via Festa del Perdono 7, 20122, Milano, Italy.
- Scoditti U Stroke Care Program, Neurology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
- Zini A Stroke Unit, Nuovo Ospedale Civile S Agostino Estense, Via Pietro Giardini 1355, 41126, Baggiovara, Modena, Italy.
- Malferrari G Department of Neuromotor Physiol, Stroke Unit, Neurology Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
- Zedde ML Department of Neuromotor Physiol, Stroke Unit, Neurology Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
- Guidetti D Department of Neurology, Guglielmo da Saliceto Hospital, Via Taverna 49, 29100, Piacenza, Italy.
- Montanari E Neurology Unit, Vaio Fidenza Hospital, Via Don Tincati 5, 43036, Fidenza, Parma, Italy.
- Baratti M Division of Neurology, B Ramazzini Hospital, Via Guido Molinari 2, 41012, Carpi, Modena, Italy.
- Denti L Clinical Geriatrics Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
- 2017-06-26
Published in:
- BMC emergency medicine. - 2017
Cartoon
Intervention mapping
Media
Pre-hospital delay
Public campaign
Stroke
Adult
Aged
Emergency Medical Services
Female
Health Education
Health Knowledge, Attitudes, Practice
Health Promotion
Humans
Male
Middle Aged
Needs Assessment
Quality Improvement
Severity of Illness Index
Stroke
Time Factors
Young Adult
English
BACKGROUND
Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness.
METHODS
Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development. In phase 1, two cross-sectional surveys were performed, one aiming to measure stroke awareness in the target population and the other to analyze the behavioral determinants of prehospital delay. In phase 2, a matrix of proximal program objectives was developed, theory-based intervention methods and practical strategies were selected and program components and materials produced.
RESULTS
In phase 1, the survey on 202 citizens highlighted underestimation of symptom severity, as in only 44% of stroke situations respondents would choose to call the emergency service (EMS). In the survey on 393 consecutive patients, 55% presented over 2 hours after symptom onset; major determinants were deciding to call the general practitioner first and the reaction of the first person the patient called. In phase 2, adult individuals were identified as the target of the intervention, both as potential "patients" and witnesses of stroke. The low educational level found in the patient survey called for a narrative approach in cartoon form. The family setting was chosen for the message because 42% of patients who presented within 2 hours had been advised by a family member to call EMS. To act on people's tendency to view stroke as an untreatable disease, it was decided to avoid fear-arousal appeals and use a positive message providing instructions and hope. Focus groups were used to test educational products and identify the most suitable sites for message dissemination.
CONCLUSIONS
The IM approach allowed to develop a stroke campaign integrating theories, scientific evidence and information collected from the target population, and enabled to provide clear explanations for the reasons behind key decisions during the intervention development process.
TRIAL REGISTRATION
NCT01881152 . Retrospectively registered June 7 2013.
Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness.
METHODS
Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development. In phase 1, two cross-sectional surveys were performed, one aiming to measure stroke awareness in the target population and the other to analyze the behavioral determinants of prehospital delay. In phase 2, a matrix of proximal program objectives was developed, theory-based intervention methods and practical strategies were selected and program components and materials produced.
RESULTS
In phase 1, the survey on 202 citizens highlighted underestimation of symptom severity, as in only 44% of stroke situations respondents would choose to call the emergency service (EMS). In the survey on 393 consecutive patients, 55% presented over 2 hours after symptom onset; major determinants were deciding to call the general practitioner first and the reaction of the first person the patient called. In phase 2, adult individuals were identified as the target of the intervention, both as potential "patients" and witnesses of stroke. The low educational level found in the patient survey called for a narrative approach in cartoon form. The family setting was chosen for the message because 42% of patients who presented within 2 hours had been advised by a family member to call EMS. To act on people's tendency to view stroke as an untreatable disease, it was decided to avoid fear-arousal appeals and use a positive message providing instructions and hope. Focus groups were used to test educational products and identify the most suitable sites for message dissemination.
CONCLUSIONS
The IM approach allowed to develop a stroke campaign integrating theories, scientific evidence and information collected from the target population, and enabled to provide clear explanations for the reasons behind key decisions during the intervention development process.
TRIAL REGISTRATION
NCT01881152 . Retrospectively registered June 7 2013.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1186/s12873-017-0130-9
- PMID 28646851
- Persistent URL
- https://sonar.ch/global/documents/112391
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