RCT: Effect of Novel Intervention to Improve Stroke Symptom Recognition

随机对照试验：新型干预措施对改善中风症状识别的效果

• 批准号: 8309376
• 负责人: Olajide Williams
• 金额: $ 68.48万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8309376
• 关键词: Accident and Emergency department; Address; Adult; Age; American; Area; Behavior Therapy; Body Weight decreased; Caregivers; Cartoons; Cause of Death; Child; Communication; Communities; Data; Development; Eating; Economically Deprived Population; Educational process of instructing; Family; Hip region structure; Home environment; Hospitals; Hour; Household; Humulus; Incidence; Intervention; Knowledge; Learning; Mass Media; Minority; Modeling; Morbidity - disease rate; Names; New York City; Parents; Patients; Persons; Pilot Projects; Population; Prophylactic treatment; Public Health; Randomized Controlled Trials; Reporting; Sampling; Schools; Stroke; Study Section; Symptoms; Testing; Therapeutic; aged; arm; base; cost; disability; follow-up; grandparent; high risk; improved; intervention effect; literacy; member; mortality; novel; programs; public health relevance; response; stroke education; success; trend; vector transmission

DESCRIPTION (provided by applicant): Stroke is the leading cause of serious long-term adult disability in the U.S. and third leading cause of death, and has a 2-fold greater incidence in Blacks compared to the majority Americans. Thrombolytic revascularization treatment administered within a maximum of 3 hours from symptom onset reduces morbidity, mortality and cost; however, only 3% of patients arrive at the hospital within 3 hours, mostly due to the public's lack of knowledge concerning stroke symptoms, and the appropriate response when they are recognized, which is to call 911. We propose to reduce these delays using a novel behavioral intervention to improve symptom recognition and response in a high-risk, minority, economically disadvantaged population. Expensive mass media stroke education campaigns are not sustainable for this purpose, particularly in economically disadvantaged populations. Instead, we propose to intervene in school classrooms with children aged 9 to 11 years, to teach the five cardinal stroke symptoms, the correct course of action when they occur, and to highlight the potential therapeutic benefit of early hospital arrival, with the intent that the children will then educate their parents. To help accomplish this, we have developed a program called Hip Hop Stroke (HHS), which is comprised of stroke rap songs and two animated musical cartoons that incorporate stroke knowledge. We have found that children aged 9-11 years can rapidly learn the information, and retain the information well for at least 2 years. One recent pilot study showed that 74% of children in the pilot (N=182) communicated the material to a parent, and that this communication significantly improved the parent's stroke literacy. Having demonstrated the efficacy of the HHS intervention in a small sample, we now propose a randomized controlled trial to test the likelihood that children can and will educate parents or adult caregivers about stroke in a high-risk, economically- disadvantaged, minority population, and parents' ability to recall knowledge transferred. Utilizing children as a "transmission vector" for carrying out interventions aimed at their parents has the potential to serve as the basis for intervention in any number of other areas such as healthy eating and weight loss. Thus, the significance of the proposed trial addresses the public health problem under study - stroke symptom identification and response - as well as development and refinement of a more general model of intervention. PUBLIC HEALTH RELEVANCE: Targeting children to intervene with their parents has been sporadically attempted and little success reported. Our model utilizes children as a "transmission vector" for carrying out interventions, in this case stroke related, aimed at their parents and grandparents in high-risk communities. Thus, the significance of the proposed trial addresses the public health problem under study - stroke symptom identification and response - as well as development and refinement of a more general model of intervention.

描述（由申请人提供）：中风是美国成人严重长期残疾的主要原因，也是第三大死因，黑人的发病率是大多数美国人的两倍。在症状出现后最多 3 小时内进行溶栓血运重建治疗可降低发病率、死亡率和费用；然而，只有 3% 的患者在 3 小时内到达医​​院，这主要是由于公众缺乏对中风症状的了解，以及在识别中风症状时缺乏适当的反应，即拨打 911。我们建议通过使用新颖的行为干预措施可改善高风险、少数族裔、经济弱势群体的症状识别和反应。为此，昂贵的大众媒体中风教育活动是不可持续的，特别是对于经济弱势群体。相反，我们建议对 9 至 11 岁儿童的学校课堂进行干预，教授五种主要中风症状以及发生这些症状时的正确行动方案，并强调早期到达医院的潜在治疗益处，目的是然后孩子们会教育他们的父母。为了帮助实现这一目标，我们开发了一个名为“嘻哈中风”(HHS) 的计划，该计划由中风说唱歌曲和两部融入中风知识的动画音乐漫画组成。我们发现9-11岁的孩子可以快速学习信息，并能很好地保留信息至少2年。最近的一项试点研究表明，试点中 74% 的儿童 (N=182) 将材料传达给了父母，这种沟通显着提高了父母的中风素养。在小样本中证明了 HHS 干预措施的有效性后，我们现在提出一项随机对照试验，以测试儿童能够并且愿意对高风险、经济弱势群体和少数群体中的父母或成年看护者进行关于中风的教育的可能性，以及父母回忆所传授知识的能力。利用儿童作为针对其父母的干预措施的“传播媒介”，有可能成为健康饮食和减肥等许多其他领域干预措施的基础。因此，拟议试验的意义在于解决正在研究的公共卫生问题——中风症状识别和反应——以及开发和完善更通用的干预模型。 公共卫生相关性：针对儿童对其父母进行干预的尝试很少，但鲜有成功报道。我们的模型利用儿童作为“传播媒介”来实施干预措施，在本例中是与中风相关的干预措施，针对高危社区的父母和祖父母。因此，拟议试验的意义在于解决正在研究的公共卫生问题——中风症状的识别和反应——以及开发和完善更通用的干预模型。