Abstract T P190: Are There Differences Between US and UK Adults in Stroke Preparedness? Evidence From Parallel Population-Based Community Surveys
Background: Given that pre-hospital delay is the main reason for tPA underutilization, increasing stroke preparedness (i.e. the ability to recognise stroke and contact EMS immediately) is crucial. We sought to determine whether between-country differences exist in stroke preparedness between two different health care systems; US (insurance-based) and UK (universal).
Methods: A survey was mailed to population-based samples in Ingham County, Michigan, USA (n=2500) and Newcastle upon Tyne, UK (n=2500). Locations were chosen based on their similar population size and rates of unemployment. Newcastle upon Tyne has a higher population density and fewer racial/ethnic minorities than Ingham County. The survey included 12 stroke and 4 non-stroke scenarios followed by a stroke recognition and behavioural intent question and recorded respondent demographics and past stroke history. Descriptive statistics were used to summarize stroke recognition and preparedness. Linear regression models explored the association of country with stroke recognition and behavioural intent after accounting for demographics and stroke history.
Results: Response rates were 27.4% (n=1369) overall (21.7% US, 33.0% UK). Respondents were on average 55 (SD=17) years old (US 56, UK 54) and 58% were female (US 56%, UK 59%). Compared to UK respondents, US respondents were better in recognizing stroke (70% vs. 63%, t(1355)=-4.9, p<0.001, d=0.27) and stating they would call EMS for witnessed stroke (55% vs. 52%, t(1365)=-2.0, p=0.045, d=0.11). Accounting for demographics and stroke history, US respondents were more likely to correctly recognize stroke (β=0.16, p<0.001) and respond appropriately (β=0.06, p=0.04) than UK respondents.
Conclusions: US respondents were better at recognising and responding to stroke based scenarios than UK respondents, but response was poor in both groups. Potential reasons for between-country effects will be discussed. Overall, significant gaps in knowledge and behavioural intent remain in both health care systems and suggest the need for aggressive public health based campaigns to improve stroke preparedness.
Author Disclosures: S. Dombrowski: None. G. Ford: None. L. Morgenstern: Research Grant; Modest; St. Jude Medical. M. White: None. F.F. Sniehotta: None. J. Mackintosh: None. P. Gellert: None. L. Skolarus: None.
- © 2014 by American Heart Association, Inc.