Rizwan Kalani, MD

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 Knowledgeof Their Parents: Tochigi Project. Stroke. 2015

The Tochigi prefecture (district), with its 2 million inhabitants, has among the highest stroke mortality rates in Japan. In this study, Matsuzono et al evaluated if teaching high school students about stroke (signs/symptoms, appropriate action at onset, risk factors, and the FAST mnemonic) could improve their parents’ knowledge about stroke in a large, high-risk community.

1127 students (13-15 years old) were enrolled along with their parents. Baseline questionnaires assessed knowledge regarding stroke of both the students and their parents. Public health workers then gave students a stroke didactic, showed a brief cartoon, and read a comic to them. This was followed by having the students take the comic home and reviewing it with their parents. Follow-up questionnaires assessing knowledge regarding stroke were then completed.

Results from questionnaires were evaluated from 1125 students and 915 parents/guardians (of which 137 were medical professionals). The number of correct answers increased significantly for all questions in students, except that corresponding to headache as a stroke symptom (60.7% prior and 94.3% after, p<0.001). Similarly, the parents answered questions correctly with significantly increased frequency except recognition of headache and hemisensory loss as acute stroke symptoms and hypertension as a risk factor (83.0% vs 92.7%, p<0.001). 91% of students and 93% of parents understood the FAST mnemonic after being taught.

This study again demonstrates that young adults and children attending school can assist in improving stroke education to high risk populations. It shows that simple, culturally-tailored, population-based approaches to improving stroke outcomes can be effectively implemented. Future work will have to evaluate if such strategies can affect outcomes (improving vascular risk factor screening/control and health-related behaviors), be applied more broadly for public health education and stroke prevention, and be improved to maximize impact.