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Erschienen in: Current Atherosclerosis Reports 12/2017

01.12.2017 | Cardiovascular Disease and Stroke (Shyam Prabhakaran, Section Editor)

Community Interventions to Increase Stroke Preparedness and Acute Stroke Treatment Rates

verfasst von: Kathleen M. Kelly, Kathryn T. Holt, Gina M. Neshewat, Lesli E. Skolarus

Erschienen in: Current Atherosclerosis Reports | Ausgabe 12/2017

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Abstract

Purpose of Review

Acute stroke treatments reduce the risk of post-stroke disability. These treatments, tissue plasminogen activator (tPA) and intra-arterial treatment, are highly time-dependent; thus, one of the main barriers to treatment is pre-hospital delay. Stroke preparedness is defined as the ability to recognize stroke symptoms and the intent to activate emergency medical services (EMS). This review describes types of acute stroke treatment and preparedness interventions, including recent mass media interventions to increase acute stroke treatment rates, and adult and youth community interventions to increase stroke preparedness.

Recent Findings

The mass media campaigns show mixed results regarding acute stroke treatment rates, possibly attributed to the various media platforms utilized and resources available. The adult and youth community interventions reveal an overall increase in stroke symptom recognition and behavioral intent to call EMS. However, most of these community interventions were not grounded in health behavior theory, and they were tested in single group, pre-post test study designs that assessed behavioral rather than clinical outcomes. The delivery of stroke preparedness information by youth to adults, for example via home assignments, is a promising and innovative approach to stroke preparedness.

Summary

Mass media and community interventions show promise to increase stroke preparedness and acute stroke treatment rates. The development of health behavior theory-based interventions that are tested via scientifically rigorous study designs are needed to prioritize which interventions should be disseminated to culturally and socially similar communities.
Literatur
1.
Zurück zum Zitat Wilkinson PR, Wolfe CDA, Warburton FG, et al. A long-term follow-up of stroke patients. Stroke. 1997;28(3):507–12.CrossRefPubMed Wilkinson PR, Wolfe CDA, Warburton FG, et al. A long-term follow-up of stroke patients. Stroke. 1997;28(3):507–12.CrossRefPubMed
2.
Zurück zum Zitat Kelly-Hayes M, Beiser A, Kase CS, Scaramucci A, D’Agostino RB, Wolf PA. The influence of gender and age on disability following ischemic stroke: the Framingham study. J Stroke Cerebrovasc Dis. 2003;12(3):119–26.CrossRefPubMed Kelly-Hayes M, Beiser A, Kase CS, Scaramucci A, D’Agostino RB, Wolf PA. The influence of gender and age on disability following ischemic stroke: the Framingham study. J Stroke Cerebrovasc Dis. 2003;12(3):119–26.CrossRefPubMed
3.
Zurück zum Zitat Hacke W, Donnan G, Fieschi C, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet. 2004;363(9411):768–74.CrossRefPubMed Hacke W, Donnan G, Fieschi C, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet. 2004;363(9411):768–74.CrossRefPubMed
4.
Zurück zum Zitat Powers WJ, Derdeyn CP, Biller J, et al. American Heart Association/American Stroke Association Focused update of the 2013 Guidelines for the Early Management of Patients with Acute Ischemic Stroke Regarding Endovascular Treatment a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015. 2015;46(10):3020–35. Powers WJ, Derdeyn CP, Biller J, et al. American Heart Association/American Stroke Association Focused update of the 2013 Guidelines for the Early Management of Patients with Acute Ischemic Stroke Regarding Endovascular Treatment a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015. 2015;46(10):3020–35.
5.
Zurück zum Zitat • Skolarus LE, Meurer WJ, Shanmugasundaram K, Adelman EE, Scott PA, Burke JF. Marked regional variation in acute stroke treatment among Medicare beneficiaries. Stroke. 2015;46(7):1890–6. A retrospective cross-sectional study of regional differences in thrombolysis rates among Medicare fee-for-service beneficiaries demonstrating substantial regional variation in thrombolysis treatment rates. These results suggest considerable opportunities to improve thromboytic treatment rates. CrossRefPubMedPubMedCentral • Skolarus LE, Meurer WJ, Shanmugasundaram K, Adelman EE, Scott PA, Burke JF. Marked regional variation in acute stroke treatment among Medicare beneficiaries. Stroke. 2015;46(7):1890–6. A retrospective cross-sectional study of regional differences in thrombolysis rates among Medicare fee-for-service beneficiaries demonstrating substantial regional variation in thrombolysis treatment rates. These results suggest considerable opportunities to improve thromboytic treatment rates. CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Kunisawa S, Morishima T, Ukawa N, et al. Association of geographical factors with administration of tissue plasminogen activator for acute ischemic stroke. J Am Heart Assoc. 2013;2(5):e000336.CrossRefPubMedPubMedCentral Kunisawa S, Morishima T, Ukawa N, et al. Association of geographical factors with administration of tissue plasminogen activator for acute ischemic stroke. J Am Heart Assoc. 2013;2(5):e000336.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Evenson KR, Foraker RE, Morris DL, Rosamond WD. A comprehensive review of prehospital and in-hospital delay times in acute stroke care. Int J stroke : Off J Int Stroke Soc. 2009;4(3):187–99.CrossRef Evenson KR, Foraker RE, Morris DL, Rosamond WD. A comprehensive review of prehospital and in-hospital delay times in acute stroke care. Int J stroke : Off J Int Stroke Soc. 2009;4(3):187–99.CrossRef
8.
Zurück zum Zitat Kleindorfer D, Kissela B, Schneider A, et al. Eligibility for recombinant tissue plasminogen activator in acute ischemic stroke: a population-based study. Stroke. 2004;35(2):e27–9.CrossRefPubMed Kleindorfer D, Kissela B, Schneider A, et al. Eligibility for recombinant tissue plasminogen activator in acute ischemic stroke: a population-based study. Stroke. 2004;35(2):e27–9.CrossRefPubMed
9.
Zurück zum Zitat Rosamond WD, Gorton RA, Hinn AR, Hohenhaus SM, Morris DL. Rapid response to stroke symptoms: the Delay in Accessing Stroke Healthcare (DASH) study. Acad Emerg Med. 1998;5(1):45–51.CrossRefPubMed Rosamond WD, Gorton RA, Hinn AR, Hohenhaus SM, Morris DL. Rapid response to stroke symptoms: the Delay in Accessing Stroke Healthcare (DASH) study. Acad Emerg Med. 1998;5(1):45–51.CrossRefPubMed
11.
Zurück zum Zitat Schroeder EB, Rosamond WD, Morris DL, Evenson KR, Hinn AR. Determinants of use of emergency medical services in a population with stroke symptoms: the Second Delay in Accessing Stroke Healthcare (DASH II) Study. Stroke. 2000;31(11):2591–6.CrossRefPubMed Schroeder EB, Rosamond WD, Morris DL, Evenson KR, Hinn AR. Determinants of use of emergency medical services in a population with stroke symptoms: the Second Delay in Accessing Stroke Healthcare (DASH II) Study. Stroke. 2000;31(11):2591–6.CrossRefPubMed
12.
Zurück zum Zitat Williams LS, Bruno A, Rouch D, Marriott DJ. Stroke patients’ knowledge of stroke. Influence on time to presentation. Stroke. 1997;28(5):912–5.CrossRefPubMed Williams LS, Bruno A, Rouch D, Marriott DJ. Stroke patients’ knowledge of stroke. Influence on time to presentation. Stroke. 1997;28(5):912–5.CrossRefPubMed
13.
Zurück zum Zitat Menon SC, Pandey DK, Morgenstern LB. Critical factors determining access to acute stroke care. Neurology. 1998;51(2):427–32.CrossRefPubMed Menon SC, Pandey DK, Morgenstern LB. Critical factors determining access to acute stroke care. Neurology. 1998;51(2):427–32.CrossRefPubMed
14.
Zurück zum Zitat Centers for Disease C. Prevention: Prehospital and hospital delays after stroke onset—United States, 2005-2006. MMWR Morb Mortal Wkly Rep. 2007;56(19):474–8. Centers for Disease C. Prevention: Prehospital and hospital delays after stroke onset—United States, 2005-2006. MMWR Morb Mortal Wkly Rep. 2007;56(19):474–8.
15.
Zurück zum Zitat Wester P, Radberg J, Lundgren B, Peltonen M. Factors associated with delayed admission to hospital and in-hospital delays in acute stroke and TIA: a prospective, multicenter study. Seek-Medical-Attention-in-Time Study Group. Stroke. 1999;30(1):40–8.CrossRefPubMed Wester P, Radberg J, Lundgren B, Peltonen M. Factors associated with delayed admission to hospital and in-hospital delays in acute stroke and TIA: a prospective, multicenter study. Seek-Medical-Attention-in-Time Study Group. Stroke. 1999;30(1):40–8.CrossRefPubMed
16.
Zurück zum Zitat Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health. 2010;31:399–418.CrossRefPubMed Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health. 2010;31:399–418.CrossRefPubMed
17.
Zurück zum Zitat Wein TH, Staub L, Felberg R, et al. Activation of emergency medical services for acute stroke in a nonurban population: the T.L.L. Temple Foundation Stroke Project. Stroke. 2000;31(8):1925–8.CrossRefPubMed Wein TH, Staub L, Felberg R, et al. Activation of emergency medical services for acute stroke in a nonurban population: the T.L.L. Temple Foundation Stroke Project. Stroke. 2000;31(8):1925–8.CrossRefPubMed
18.
Zurück zum Zitat Kothari RU, Pancioli A, Liu T, Brott T, Broderick J. Cincinnati prehospital stroke scale: reproducibility and validity. Ann Emerg Med. 1999;33(4):373–8.CrossRefPubMed Kothari RU, Pancioli A, Liu T, Brott T, Broderick J. Cincinnati prehospital stroke scale: reproducibility and validity. Ann Emerg Med. 1999;33(4):373–8.CrossRefPubMed
19.
Zurück zum Zitat Mellon L, Hickey A, Doyle F, Dolan E, Williams D. Can a media campaign change health service use in a population with stroke symptoms? Examination of the first Irish stroke awareness campaign. Emerg Med J 2013. Mellon L, Hickey A, Doyle F, Dolan E, Williams D. Can a media campaign change health service use in a population with stroke symptoms? Examination of the first Irish stroke awareness campaign. Emerg Med J 2013.
20.
Zurück zum Zitat Nishijima H, Kon T, Ueno T, et al. Effect of educational television commercial on pre-hospital delay in patients with ischemic stroke. Neurol Sci. 2016;37(1):105–9.CrossRefPubMed Nishijima H, Kon T, Ueno T, et al. Effect of educational television commercial on pre-hospital delay in patients with ischemic stroke. Neurol Sci. 2016;37(1):105–9.CrossRefPubMed
21.
Zurück zum Zitat • Flynn D, Ford GA, Rodgers H, Price C, Steen N, Thomson RG. A time series evaluation of the FAST national stroke awareness campaign in England. 2014. Interrupted time series analysis of the UK FAST campaign demonstrating an increase in emergency department (ED) stroke presentations and acute stroke treatment rates over time. • Flynn D, Ford GA, Rodgers H, Price C, Steen N, Thomson RG. A time series evaluation of the FAST national stroke awareness campaign in England. 2014. Interrupted time series analysis of the UK FAST campaign demonstrating an increase in emergency department (ED) stroke presentations and acute stroke treatment rates over time.
22.
Zurück zum Zitat Bray JE, Straney L, Barger B, Finn J. Effect of public awareness campaigns on calls to ambulance across Australia. Stroke. 2015;46(5):1377–80.CrossRefPubMed Bray JE, Straney L, Barger B, Finn J. Effect of public awareness campaigns on calls to ambulance across Australia. Stroke. 2015;46(5):1377–80.CrossRefPubMed
23.
Zurück zum Zitat Dombrowski SU, Mackintosh JE, Sniehotta FF, et al. The impact of the UK ‘Act FAST’ stroke awareness campaign: content analysis of patients, witness and primary care clinicians’ perceptions. BMC Public Health. 2013;13(1):915.CrossRefPubMedPubMedCentral Dombrowski SU, Mackintosh JE, Sniehotta FF, et al. The impact of the UK ‘Act FAST’ stroke awareness campaign: content analysis of patients, witness and primary care clinicians’ perceptions. BMC Public Health. 2013;13(1):915.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Trobbiani K, Freeman K, Arango M, Lalor E, Jenkinson D, Thrift AG. Comparison of stroke warning sign campaigns in Australia, England, and Canada. Int J Stroke. 2013;8(A100):28–31.CrossRefPubMed Trobbiani K, Freeman K, Arango M, Lalor E, Jenkinson D, Thrift AG. Comparison of stroke warning sign campaigns in Australia, England, and Canada. Int J Stroke. 2013;8(A100):28–31.CrossRefPubMed
25.
Zurück zum Zitat Wakefield MA, Loken B, Hornik RC. Use of mass media campaigns to change health behaviour. The Lancet. 2010;376(9748):1261–71.CrossRef Wakefield MA, Loken B, Hornik RC. Use of mass media campaigns to change health behaviour. The Lancet. 2010;376(9748):1261–71.CrossRef
26.
Zurück zum Zitat Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef
27.
Zurück zum Zitat Gardois P, Booth A, Goyder E, Ryan T. Health promotion interventions for increasing stroke awareness in ethnic minorities: a systematic review of the literature. BMC public health. 2014;14(1):409.CrossRefPubMedPubMedCentral Gardois P, Booth A, Goyder E, Ryan T. Health promotion interventions for increasing stroke awareness in ethnic minorities: a systematic review of the literature. BMC public health. 2014;14(1):409.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Yang L, Zhao Q, Zhu X, et al. Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers. Qual Life Res. 2017:1–8. Yang L, Zhao Q, Zhu X, et al. Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers. Qual Life Res. 2017:1–8.
29.
Zurück zum Zitat Kilkenny MF, Purvis T, Werner M, Reyneke M, Czerenkowski J, Cadilhac DA. Improving stroke knowledge through a ‘volunteer-led’ community education program in Australia. Prev Med. 2016;86:1–5.CrossRefPubMed Kilkenny MF, Purvis T, Werner M, Reyneke M, Czerenkowski J, Cadilhac DA. Improving stroke knowledge through a ‘volunteer-led’ community education program in Australia. Prev Med. 2016;86:1–5.CrossRefPubMed
30.
Zurück zum Zitat Skolarus LE, Zimmerman MA, Bailey S, et al. Stroke ready intervention: community engagement to decrease prehospital delay. J Am Heart Assoc. 2016;5(5):e003331.CrossRefPubMedPubMedCentral Skolarus LE, Zimmerman MA, Bailey S, et al. Stroke ready intervention: community engagement to decrease prehospital delay. J Am Heart Assoc. 2016;5(5):e003331.CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Ravenell J, Leighton-Herrmann E, Abel-Bey A, et al. Tailored approaches to stroke health education (TASHE): study protocol for a randomized controlled trial. Trials. 2015;16(1):176.CrossRefPubMedPubMedCentral Ravenell J, Leighton-Herrmann E, Abel-Bey A, et al. Tailored approaches to stroke health education (TASHE): study protocol for a randomized controlled trial. Trials. 2015;16(1):176.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Williams O, Leighton-Herrmann E, DeSorbo A, et al. Effect of two 12-minute culturally targeted films on intent to call 911 for stroke. Neurology. 2016;86(21):1992–5.CrossRefPubMedPubMedCentral Williams O, Leighton-Herrmann E, DeSorbo A, et al. Effect of two 12-minute culturally targeted films on intent to call 911 for stroke. Neurology. 2016;86(21):1992–5.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Williams O, DeSorbo A, Noble J, Gerin W. Child-mediated stroke communication. Stroke. 2012;43(1):163–9.CrossRefPubMed Williams O, DeSorbo A, Noble J, Gerin W. Child-mediated stroke communication. Stroke. 2012;43(1):163–9.CrossRefPubMed
35.
Zurück zum Zitat Shigehatake Y, Yokota C, Amano T, 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.CrossRefPubMed Shigehatake Y, Yokota C, Amano T, 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.CrossRefPubMed
36.
Zurück zum Zitat Amano T, Yokota C, Sakamoto Y, et al. Stroke education program of act FAST for junior high school students and their parents. J Stroke Cerebrovasc Dis. 2014;23(5):1040–5.CrossRefPubMed Amano T, Yokota C, Sakamoto Y, et al. Stroke education program of act FAST for junior high school students and their parents. J Stroke Cerebrovasc Dis. 2014;23(5):1040–5.CrossRefPubMed
37.
Zurück zum Zitat Sakamoto Y, Yokota C, Miyashita F, et al. Effects of stroke education using an animated cartoon and a manga on elementary school children. J Stroke Cerebrovasc Dis. 2014;23(7):1877–81.CrossRefPubMed Sakamoto Y, Yokota C, Miyashita F, et al. Effects of stroke education using an animated cartoon and a manga on elementary school children. J Stroke Cerebrovasc Dis. 2014;23(7):1877–81.CrossRefPubMed
38.
Zurück zum Zitat 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. Int J Stroke. 2017;12(4):401–11.CrossRefPubMed 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. Int J Stroke. 2017;12(4):401–11.CrossRefPubMed
39.
Zurück zum Zitat Sharkey S, Denke L, Herbert MA. Using puppets to teach schoolchildren to detect stroke and call 911. J Sch Nurs. 2016;32(4):228–33.CrossRefPubMed Sharkey S, Denke L, Herbert MA. Using puppets to teach schoolchildren to detect stroke and call 911. J Sch Nurs. 2016;32(4):228–33.CrossRefPubMed
41.
Zurück zum Zitat Williams O, Hecht MF, DeSorbo AL, Huq S, Noble JM. Effect of a novel video game on stroke knowledge of 9- to 10-year-old, low-income children. Stroke. 2014;45(3):889–92.CrossRefPubMedPubMedCentral Williams O, Hecht MF, DeSorbo AL, Huq S, Noble JM. Effect of a novel video game on stroke knowledge of 9- to 10-year-old, low-income children. Stroke. 2014;45(3):889–92.CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Williams O, Leighton-Herrmann E, DeSorbo A, et al: Hip hop stroke: study protocol for a randomized controlled trial to address stroke literacy. J Clin Trials 2015, 5(5). Williams O, Leighton-Herrmann E, DeSorbo A, et al: Hip hop stroke: study protocol for a randomized controlled trial to address stroke literacy. J Clin Trials 2015, 5(5).
43.
Zurück zum Zitat Matsuzono K, Yokota C, Takekawa H, et al. Effects of stroke education of junior high school students on stroke knowledge of their parents. Stroke. 2015;46(2):572–4.CrossRefPubMed Matsuzono K, Yokota C, Takekawa H, et al. Effects of stroke education of junior high school students on stroke knowledge of their parents. Stroke. 2015;46(2):572–4.CrossRefPubMed
44.
Zurück zum Zitat Williams LS, Bruno A, Rouch D, Marriott DJ, MAS DJ. Stroke patients’ knowledge of stroke: influence on time to presentation. Stroke. 1997;28(5):912–5.CrossRefPubMed Williams LS, Bruno A, Rouch D, Marriott DJ, MAS DJ. Stroke patients’ knowledge of stroke: influence on time to presentation. Stroke. 1997;28(5):912–5.CrossRefPubMed
45.
Zurück zum Zitat Fussman C, Rafferty AP, Lyon-Callo S, Morgenstern LB, Reeves MJ. Lack of association between stroke symptom knowledge and intent to call 911. Stroke. 2010;41(7):1501–7.CrossRefPubMed Fussman C, Rafferty AP, Lyon-Callo S, Morgenstern LB, Reeves MJ. Lack of association between stroke symptom knowledge and intent to call 911. Stroke. 2010;41(7):1501–7.CrossRefPubMed
46.
Zurück zum Zitat Dombrowski SU, Sniehotta FF, Mackintosh J, et al. Witness response at acute onset of stroke: a qualitative theory-guided study. PloS one. 2012;7(7):e39852.CrossRefPubMedPubMedCentral Dombrowski SU, Sniehotta FF, Mackintosh J, et al. Witness response at acute onset of stroke: a qualitative theory-guided study. PloS one. 2012;7(7):e39852.CrossRefPubMedPubMedCentral
47.
Zurück zum Zitat Skolarus LE, Murphy JB. Zimmerman MA, et al: individual and community determinants of calling 911 for stroke among African Americans in an urban community. Circ: Cardiovasc Qual Outcome. 2013;6(3):278–83. Skolarus LE, Murphy JB. Zimmerman MA, et al: individual and community determinants of calling 911 for stroke among African Americans in an urban community. Circ: Cardiovasc Qual Outcome. 2013;6(3):278–83.
48.
Zurück zum Zitat Nemeth LS, Jenkins C, Jauch EC, et al. A community-engaged assessment of barriers and facilitators to rapid stroke treatment. Res Nurs Health. 2016;39(6):438–48.CrossRefPubMedPubMedCentral Nemeth LS, Jenkins C, Jauch EC, et al. A community-engaged assessment of barriers and facilitators to rapid stroke treatment. Res Nurs Health. 2016;39(6):438–48.CrossRefPubMedPubMedCentral
49.
50.
Zurück zum Zitat Morgenstern LB, Staub L, Chan W, et al. Improving delivery of acute stroke therapy. Stroke. 2002;33(1):160–6.CrossRefPubMed Morgenstern LB, Staub L, Chan W, et al. Improving delivery of acute stroke therapy. Stroke. 2002;33(1):160–6.CrossRefPubMed
51.
Zurück zum Zitat •• Rasura M, Baldereschi M, Di Carlo A, et al. Effectiveness of public stroke educational interventions: a review. Eur J Neurol. 2014;21(1):11–20. Narrative synthesis of public education interventions which suggests the importance of community interventions and e-health. CrossRefPubMed •• Rasura M, Baldereschi M, Di Carlo A, et al. Effectiveness of public stroke educational interventions: a review. Eur J Neurol. 2014;21(1):11–20. Narrative synthesis of public education interventions which suggests the importance of community interventions and e-health. CrossRefPubMed
52.
Zurück zum Zitat Beal CC, Flanders SA, Bader SG. Can children reduce delayed hospital arrival for ischemic stroke?: A systematic review of school-based stroke education. J Neurosci Nurs. 2016;48(3):E2–E13.CrossRefPubMed Beal CC, Flanders SA, Bader SG. Can children reduce delayed hospital arrival for ischemic stroke?: A systematic review of school-based stroke education. J Neurosci Nurs. 2016;48(3):E2–E13.CrossRefPubMed
53.
Zurück zum Zitat •• Mellon L, Doyle F, Rohde D, Williams D, Hickey A. Stroke warning campaigns: delivering better patient outcomes? A systematic review. Patient related outcome measures 2015, 6:61. A systematic review of stroke waning campaigns that demonstrated the positive effects of most studies. However, there were methodological limitations. •• Mellon L, Doyle F, Rohde D, Williams D, Hickey A. Stroke warning campaigns: delivering better patient outcomes? A systematic review. Patient related outcome measures 2015, 6:61. A systematic review of stroke waning campaigns that demonstrated the positive effects of most studies. However, there were methodological limitations.
Metadaten
Titel
Community Interventions to Increase Stroke Preparedness and Acute Stroke Treatment Rates
verfasst von
Kathleen M. Kelly
Kathryn T. Holt
Gina M. Neshewat
Lesli E. Skolarus
Publikationsdatum
01.12.2017
Verlag
Springer US
Erschienen in
Current Atherosclerosis Reports / Ausgabe 12/2017
Print ISSN: 1523-3804
Elektronische ISSN: 1534-6242
DOI
https://doi.org/10.1007/s11883-017-0695-5

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