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Stroke. 2008;39:2809-2816
Published online before print July 17, 2008, doi: 10.1161/STROKEAHA.107.513143
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(Stroke. 2008;39:2809.)
© 2008 American Heart Association, Inc.


Original Contributions

‘Hip-Hop’ Stroke

A Stroke Educational Program for Elementary School Children Living in a High-Risk Community

Olajide Williams, MD, MSc James M. Noble, MD

From the Department of Neurology (O.W.), Harlem Hospital and Columbia University Medical Center, New York, NY; and the Department of Neurology and GH Sergievsky Center (J.M.N.), Columbia University Medical Center, New York, NY.

Correspondence to Olajide Williams, MD, MSc, Department of Neurology, Harlem Hospital Center, 506 Lenox Avenue, New York, NY 10037. E-mail ow11{at}columbia.edu

Background and Purpose— Public stroke recognition is poor and poses a barrier to acute stroke treatment. We describe a stroke literacy program that teaches elementary school children in high-risk communities to recognize stroke and form an urgent action plan; we then present results of an intervention study using the program.

Methods— "Hip-Hop" Stroke uses culturally and age-appropriate music and dance to enhance an interactive didactic curriculum including the FAST mnemonic (Facial droop, Arm weakness, Speech disturbance, Time to call 911). The program occurred in central Harlem, New York City, a community with high stroke risk. During the 2006 to 2007 school year, 582 fourth, fifth, and sixth graders (9 to 11 years of age) participated in 1-hour sessions over 3 consecutive days. Stroke knowledge was tested before and after the program with a 94% group participant retention.

Results— Students learned and retained knowledge well for stroke localization (20% correct before intervention, 93% correct immediately afterward, and 86% correct after 3-month delay; P<0.001 both posttests versus baseline), the term "brain attack" (16% pretest, 95% immediate, 86% delayed; P<0.001), and to call 911 for stroke (78% pretest, 99.8% immediate, 98% delayed; P<0.001). FAST stroke symptoms (facial droop and slurred speech) were better retained than non-FAST symptoms (headache and blurred vision) at 3 months (P<0.001). For stroke prevention measures, dietary change and exercise were better learned than concepts of diabetes, hypertension, and cholesterol.

Conclusions— Elementary school children are educable about stroke, retain their knowledge well, and may be able to appropriately activate emergency services for acute stroke. Incorporating cultural elements such as hip-hop music may improve retention of stroke knowledge among the youth.


Key Words: African-Americans • cerebrovascular accident • child • health education • health literacy


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