Neal S Parikh, MD

Williams O, Leighton-Herrmann Quinn E, Teresi J, Eimicke JP, Kong J, Ogedegbe G, et al. Improving Community Stroke Preparedness in the HHS (Hip-Hop Stroke) Randomized Clinical Trial. Stroke. 2018

Dr. Williams and colleagues recently published the results of their well-designed stroke education intervention study. I invite readers to consider and appreciate the merits of this study and this type of intervention.

Most patients with acute ischemic stroke are not treated with IV-tPA, and this is, in large part, due to delays to medical presentation. Universally, this is due to low awareness of stroke symptoms, and lack of awareness may magnify related disparities. The Hip-Hop Stroke program seeks to address this root cause issue by increasing awareness and stroke preparedness among children and their families through educational initiatives.

The study randomized children to a multifaceted educational intervention or attentional control and then assessed child and parental stroke knowledge and preparedness at several time points. The intervention included music, cartoons, a videogame, and a comic book. Here is a link to a video from the group: I recommend watching it. Well-validated research instruments were used to measure preparedness and knowledge.

3070 students and 1144 parents enrolled. There was attrition, and it was accounted for statistically. The bottom line: The educational intervention produced lasting, meaningful changes in stroke preparedness and knowledge in both children and their parents out to 3 months. Child stroke preparedness was associated with parent stroke preparedness. Between this group’s several studies, they have had a total of 6 ‘intervention arm’ children call 911 for real-life stroke seen in family members.

Precision medicine presupposes that individuals recognize health problems and then seek healthcare, at which point cutting edge science can be used to optimize individual outcomes. This progress cannot reach individuals who are not empowered through knowledge to seek care when necessary, such that disparities may continue to arise. By addressing the gaps in awareness, efforts such as Hip-Hop Stroke ensure that the general population can benefit from already routinely available therapies. Population health and precision medicine are not mutually exclusive, but it is nonetheless refreshing to see an effort that targets a root cause despite the challenges of such research.