SWIFT: Stroke Warning Information and Faster Treatment

急性缺血性脑卒中的快速诊断和治疗对于降低发病率、致残率和卒中相关死亡率至关重要。虽然静脉注射rt-PA是唯一被批准的治疗急性缺血性卒中的方法，但只有不到2-3%的符合条件的患者接受了治疗。rt-PA未得到充分利用的原因有很多。最重要的是无法捕捉急性缺血性中风病例在症状发作的三个小时内。中风风险最高的人群在出现中风症状后立即采取快速紧急干预措施的必要性方面仍然受到的教育严重不足。在包括非洲裔美国人、西班牙裔美国人和穷人在内的弱势群体中尤其如此。我们的主要目的是确定一个名为SWIFT（中风预警信息和快速治疗）的三期文化敏感互动教育项目是否在种族和民族多样化的高危人群中比常规护理更有效。干预的目标是增加卒中知识，改变行为，并在卒中症状发作时缩短到达急诊科的时间。为了实现这些目标，我们计划将1400名卒中/TIA患者和1200名无卒中社区居民随机分为SWIFT干预组和常规护理组。所有参与者将在干预前后（30天和1年）接受卒中知识/行为调查。综合监测方法将测量研究参与者在研究期间急性中风的到达时间。我们的目标是证明促进快速识别中风症状的互动策略；传达获得紧急医疗的紧迫性；此外，在紧急护理的导航帮助将提高中风的认识和减少个人的反应时间挽救生命的中风治疗。

The rapid diagnosis and treatment of acute ischemic stroke is critical in the reduction of morbidity, disability and stroke-associated mortality. While intravenous rt-PA is the only approved treatment for acute ischemic stroke, less than 2-3% of eligible individuals receive treatment. There are a number of reasons for the underutilization of rt-PA. Foremost is the inability to capture acute ischemic stroke cases within three hours of symptom onset. Populations at highest risk for stroke are still significantly undereducated about the need for rapid, emergency intervention immediately following onset of stroke symptoms. This is especially true among vulnerable populations including African Americans, Hispanics and the poor. Our primary objective is to determine whether a three session culturally sensitive interactive educational program called SWIFT (Stroke Warning Information and Faster Treatment) is more effective than usual care among a racially and ethnically diverse high-risk population. The goal of the intervention is to increase stroke knowledge, change behavior, and improve the time of arrival to the ED upon onset of stroke symptoms. To accomplish these aims we plan to randomize 1400 stroke/TIA patients and 1200 stroke free community residents into the SWIFT intervention versus usual care. All participants will be administered pre and post (30 days and 1 year) intervention stroke knowledge/behavior surveys. Comprehensive surveillance methodologies will measure arrival times for acute stroke among study participants for the length of the study. Our goal is to demonstrate that interactive strategies which promote the rapid identification of stroke symptoms; impart an urgency to obtain emergency medical treatment; and, aid in the navigation of emergency care will increase stroke awareness and decrease the individuals' response time to life saving stroke therapy.