| Pontes-Neto et al., 2008 [99 Pontes-Neto OM, Silva GS, Feitosa MR, Figueiredo NL, Fiorot Jr JA, Rocha TN, et al. Stroke awareness in Brazil. Stroke 2008;39(2):292–6.] Brazil |
n=801
General public
Mean age: ~39 y.o. (range: 18‒80 y.o.)
~54% of women
|
Cross-sectional Interview survey |
None: ~19%
Hypertension: ~30%
Diabetes: ~2%
Smoking: ~50%
Dyslipidemia: ~15%
Obesity: ~5%
Alcohol consumption: ~21%
|
None: ~22% |
EMS phone number: ~35%
EMS activation at onset: ~51% Willingness to go to the emergency department by own means: ~40%
|
Alarming lack of knowledge on EMS activation and patient treatment |
| Robinson et al., 2013 [1010 Robinson TG, Reid A, Haunton VJ, Wilson A, Naylor AR. The face arm speech test: does it encourage rapid recognition of important stroke warning symptoms? Emerg Med J 2013;30(6):467–71.] United Kingdom |
n=1300
General public
Mean age: ~49 y.o. (range: 10‒87 y.o.) ~61% of women
|
Cross-sectional
Interview survey
|
Hypertension: ~90%
Diabetes: ~51%
Smoking: ~74%
Alcohol consumption: ~54%
|
Facial droop: ~89%
Arm weakness: ~83%
Slurred speech: ~91%
|
Brain (site of stroke): ~68% |
The FAST campaign was effective for raising public stroke awareness |
| Panicio et al., 2014 [77 Panício MI, Mateus L, Ricarte IF, Figueiredo MM, Fukuda TG, Seixas JC, et al. The influence of patient's knowledge about stroke in Brazil: a cross-sectional study. Arq Neuro-Psiq 2014;72(12):938–41.] Brazil |
n=104
Acute stroke patients and their families
Mean age: ~64 y.o.
~45% of women
|
Cross-sectional
Interview survey
|
Not provided |
Recognition: ~66% |
Not provided |
Lack of knowledge about the therapeutic time window may affect early hospital arrival despite WSS knowledge |
| Shigehatake et al., 2014 [1111 Shigehatake Y, Yokota C, Amano T, Tomii Y, Inoue Y, Hagihara T, Toyoda K, et al. Stroke education using an animated cartoon and a manga for junior high school students. J Stroke Cerebrovasc Dis 2014;23(6):1623–7.] Japan |
n = 493
Students (10th grade) (range 12‒13 y.o.)
|
Cohort
Questionnaires
|
Hypertension: ~76%
Hyperglycemia: ~52%
Smoking: ~54%
Dyslipidemia: ~55%
Obesity: ~22%
Alcohol consumption: ~72%
|
Facial droop: ~33%
Hemiparesis: ~52%
Slurred speech: ~60%
Sudden headache: ~55%
|
EMS activation at onset: ~85% |
Manga and other educational materials can improve students' stroke knowledge |
| Yang et al., 2014 [2121 Yang J, Zheng M, Cheng S, Ou S, Zhang J, Wang N, et al. Knowledge of stroke symptoms and treatment among community residents in western urban China. J Stroke Cerebrovasc Dis 2014;23(5):1216–24.] China |
n=1101
General public
Mean age: ~58 y.o. (range: 18‒91 y.o.)
~62% of women
|
Cross-sectional
Interview survey
|
Not provided |
None: ~13%
Facial or limb weakness: ~76%
Slurred speech: ~69%
Sudden headache: ~36%
|
EMS activation at onset: ~28‒43% |
Low stroke awareness and response at the onset, particularly by the lower education level and older people |
| Ntaios G et al., 2015 [1313 Ntaios G, Melikoki V, Perifanos G, Perlepe K, Gioulekas F, Karagiannaki A, et al. Poor stroke risk perception despite moderate public stroke awareness: insight from a cross-sectional national survey in Greece. J Stroke Cerebrovasc Dis 2015;24(4):721–4.] Greece |
n=723
Mean age ~47 y.o.
General public ~58% of women
|
Cross-sectional
Interview survey (by phone)
|
Hypertension: ~66%
Smoking: ~44%
Obesity: ~34%
|
Facial droop: ~38%
Arm or leg paralysis: ~49%
Slurred speech: ~44%
|
EMS activation at onset or willingness to go to the emergency department by own means: ~69% |
Stroke knowledge is moderately poor in general, and it is important to develop new educational strategies to improve stroke risk perception |
| Matsuzono et al., 2015 [2020 Matsuzono K, Yokota C, Takekawa H, Okamura T, Miyamatsu N, Nakayama H, et al. Effects of stroke education of junior high school students on stroke knowledge of their parents. Stroke 2015;46(2):572–4.] Japan |
n=2040
Students (10th‒12th grades) and their parents
|
Cohort
Questionnaires
|
Students and their parents:
Hypertension: ~82% and ~91%
Diabetes: ~57% and ~46%
Smoking: ~64% and ~82%
Dyslipidemia: ~58% and ~73%
Overweight: ~28% and ~51%
|
Students and their parents:
Facial droop: ~45% and ~71%
Arm weakness: ~58% and ~73%
Slurred speech: ~63% and ~91%
Sudden headache: ~68% and ~81%
|
EMS activation at onset: ~61% and ~83% |
Manga and other educational materials can improve students' stroke knowledge, and their parents also learn through the children's communication of what they learned |
| Ramírez-Moreno et al., 2015 [2323 Ramírez-Moreno JM, Alonso-González R, Peral-Pacheco D, Millán-Núñez MV, Aguirre-Sanchez JJ. Knowledge of stroke a study from a sex perspective. BMC Res Notes 2015;8(1):604–12.] Spain |
n=2409
General Public
Mean age: ~66 y.o.
~60% of women
|
Cross-sectional
Interview survey
|
Men and women:
Hypertension: ~33% and ~41%
Diabetes: ~13% and ~15%
Smoking: ~54% and ~48%
Dyslipidemia: ~25% both
Obesity: ~15% and ~13%
Alcohol consumption: ~48% and ~40%
|
Men and women:
Paralysis or weakness: ~32 and ~31%
Slurred speech: ~11% and ~13%
Sudden headache: ~30% and ~31%
|
Men and women:
EMS activation at onset or willingness to go to the emergency department by own means: ~45 and 39%
Brain (site of stroke): ~71 and 72%
|
Lack of knowledge in the general public. Women perform better in general. |
| Kilkenny et al., 2016 [1414 Kilkenny MF, Purvis T, Werner M, Reyneke M, Czerenkowski J, Cadilhac DA. Improving stroke knowledge through a ‘volunteer-led’ community education program in Australia. Prevent Med 2016;86:1–5.] Australia |
n=591
General Public
~68% of women
|
Cohort
Questionnaires
|
Hypertension: ~89%
Diabetes: ~36%
Smoking: ~62%
Dyslipidemia: ~58%
Alcohol consumption: ~27%
|
Facial droop: ~86%
Arm weakness: ~81%
Slurred speech: ~91%
|
EMS activation if observed facial droop: ~92% |
Educational programs towards stroke awareness can effectively improve the general public knowledge of stroke |
| Park et al., 2017 [1515 Park H, Jeong J, Lee H, Lee S, Suk S. Stroke awareness in Korean high school students. Acta Neurol Belg 2017;117(2):455–9.] Korea |
n=1052
Students (11‒12th grade)
|
Cohort
Questionnaires
|
Hypertension: ~57%
Diabetes: ~36%
Smoking: ~49%
Dyslipidemia: ~63%
Obesity: ~51%
Alcohol consumption: ~51%
|
Arm or leg paralysis: ~26%
Sudden headache: ~6%
|
EMS activation at onset: ~80%
Brain (site of stroke): ~74%
|
Associated risk factors and warning signs and symptoms are important areas to address |
| Marto et al., 2017 [1616 Marto JP, Borbinha C, Filipe R, Calado S, Viana-Baptista M. Impact of stroke education on middle school students and their parents: a cluster randomized trial. Intern J Stroke 2016;12(4):401–11.] Portugal |
n=1108
Students (8th grade) and their parents
Mean age: ~23 y.o.
|
Randomized trial
Questionnaires
|
Students and their parents:
Hypertension: ~63% and ~80%
Diabetes: ~21% and ~29%
Smoking: ~37% and ~61%
Dyslipidemia: ~53% and ~77%
Obesity: ~39% and ~76%
Alcohol consumption: ~37% both
|
Students and their parents:
Facial droop: ~25% and ~63%
Arm weakness: ~40% and ~65%
Slurred speech: ~40% and ~65%
|
Students and their parents:
EMS activation at onset: ~45% and ~56%
Brain (site of stroke): ~84% and ~75%
|
Lectures at school for students and their parents increased stroke knowledge |
| Umar et al., 2019 [88 Umar AB, Koehler TJ, Zhang R, Gilbert V, Farooq MU, Davis AT, et al. Stroke knowledge among middle and high school students. J Intern Med Res 2019;47 (9):4230–41.] United States |
n=603
Students (7th‒12th grade)
Mean age: ~15 y.o. (range: 12‒18 y.o.)
~50% of women
|
Cross-sectional
Paper-and-pencil survey
|
Recognition: ~11% |
FAST acronym: ~56% |
EMS phone number: ~65%
Brain (site of stroke): ~50%
|
Mothers'educational level and race were associated with greater stroke knowledge with an alarming lack of knowledge on risk factors and symptoms at middle and high school |
| Dossi et al., 2019 [1717 Dossi DE, Hawkes MA, Pujol-Lereis VA, Povedano GP, Rodríguez-Lucci F, Farez MF, et al. A population-based survey of stroke knowledge in Argentina: The SIFHON Study. Neuroepidemiol 2019;53(1-2):32–40.] Argentina |
n = 12,710
General public
Mean age: ~51 y.o.
~69% of women
|
Cross-sectional
Household survey
|
Hypertension: ~69%
Dyslipidemia: ~69%
Stroke is preventable: ~67%
Lifestyle measures are useful: ~58%
|
Recognition: ~73%
Sudden headache: ~66%
|
EMS activation at onset: ~26%
Willingness to go to the emergency department by own means: ~52%
|
Stroke knowledge is moderate with poor-risk perception, requiring educational programs |
| Houessou et al., 2021 [1818 Houessou MA, Hountada H, Yahouédéou B, Choki B, Kossi O, Adoukonou T. Knowledge of stroke risk factors and signs in Parakou, a Northern City of Benin in West Africa. Cerebrovasc Dis 2021;50(1):88–93.] Benin |
n=4671
General public
Mean age: ~28 y.o. (range: 15‒99 y.o.) ~51% of women
|
Cross-sectional
Household survey
|
None: ~91% |
None: ~95% |
Not provided |
Age, educational level, and prior experience were associated with stroke knowledge |
| Calderaro et al., 2021 [current] Brazil |
n=3954
Students (2nd to 18th grade)
Mean age: ~18 y.o. (range: 7‒69 y.o.) ~58% of women
|
Cross-sectional
Paper-and-pencil and online survey
|
(a) Elementary/Middle School:
None: ~51%
Hypertension: ~18%
Dyslipidemia: ~33%
Diabetes: ~22%
Smoking: ~28%
(b) High School:
None: ~46%
Hypertension: ~33%
Dyslipidemia: ~39%
Diabetes: ~27%
Smoking: ~21%
(c) University:
None: ~14%
Hypertension: ~80%
Dyslipidemia: ~69%
Diabetes: ~36%
Smoking: ~55%
|
(a) Elementary/Middle School
None: ~46%
Facial droop: ~33%
Arm weakness: ~32%
Slurred speech: ~34%
Sudden headache: ~15%
(b) High School:
None: ~32%
Facial droop: ~51%
Arm weakness: ~47%
Slurred speech: ~49%
Sudden headache: ~22%
(c) University:
None: ~6%
Facial droop: ~86%
Arm weakness: ~86%
Slurred speech: ~90%
Sudden headache: ~68%
|
(a) Elementary/Middle School:
EMS phone number: ~63%
Brain (site of stroke): ~56%
(b) High School:
EMS phone number: ~76%
Brain (site of stroke): ~78%
(c) University:
EMS phone number: ~66%
EMS phone number: ~66%
|
Having a higher educational level, being female, and having prior experience increase the identification of associated risk factors and warning signs and symptoms. Stroke awareness should be emphasized among schoolchildren and adolescents. |
