Tailored Approaches to Stroke Health Education

中风是成人残疾的主要原因，每年花费美国纳税人超过600亿美元。干预措施 旨在教育患者在中风发生时尽早寻求治疗的方法可能会增加低发病率， 溶栓治疗（目前全国平均比率为3%）。溶栓可以增加 如果紧急医疗系统响应时间和院内响应， 优化时间（从症状发作到静脉溶栓的最长时间为4.5小时）。黑色 与白人相比，西班牙裔美国人的中风发病率更高， 溶栓治疗急性中风。到达医院的延迟在很大程度上取决于患者对 出现中风症状，并立即到急诊室就诊。我们小组发现 与白人相比，黑人和西班牙裔人的中风识字率，这可能是导致 急性中风治疗的差异。在我们以前的工作基础上，我们已经确定了 提高中风素养和拨打911的行为意图，我们将开发和评估 一种新颖的，文化定制的干预，使用两种形式的讲故事（叙事说服） 专业制作12分钟的电影（英语和西班牙语），在纽约市的少数民族人口。这部电影将 (1)（2）沟通中风症状的知识;（2）沟通中风的严重程度范围， 可能出现症状（例如，轻微的言语不清应足以促使采取行动）;（3） 传达呼叫911的治疗益处和（4）克服去艾德的自然不情愿， 如果症状并不严重，则会产生与否认或尴尬有关的障碍。一个跨学科 团队成员包括当地黑人和西班牙裔教堂的社区成员，中风专家，行为 科学家，包括叙事传播专家，知识获取理论专家， 专业的电影制作人将指导干预的开发和制作，这将是交付 在教堂里

Stroke is the leading cause of adult disability and costs U.S. taxpayers >$60 billion annually. Interventions designed to educate patients to seek treatment sooner when a stroke occurs may increase low rates of treatment with thrombolysis (current rates 3% national average). Thrombolysis can increase the odds of minimal to zero disability from stroke if emergency medical system response times and in-hospital response times are optimized (maximum time from symptom onset to intravenous thrombolysis is 4.5 hours). Black and Hispanic Americans have higher stroke incidence compared to Whites and are less likely to receive thrombolysis for acute stroke. The latency to hospital arrival is largely dependent on patients' recognition of stroke symptoms, and immediate presentation to the emergency department. Our group has found very low stroke literacy rates among Blacks and Hispanics compared to Whites, which may, in part, be responsible for disparities in acute stroke treatment. Building on our previous work, in which we have identified barriers to increasing stroke literacy and behavioral intent to call 911, we will develop and evaluate the effectiveness of a novel, culturally tailored intervention using storytelling (narrative persuasion) in the form of two professionally produced 12-min films (in English and Spanish), in minority populations in NYC. The film will (1) communicate knowledge of stroke symptoms; (2) communicate the range of severity with which the symptom may occur (a slight slurring of the speech, for example, should be enough to precipitate action); (3) communicate the therapeutic benefit of calling 911 and (4) overcome the natural reluctance to go to the ED, and barriers related to denial or embarrassment if symptoms turn out not to be serious. A transdisciplinary team comprising community members from local Black and Hispanic churches, a stroke expert, behavioral scientists including narrative communication experts, a specialist in theory of knowledge acquisition, and a professional filmmaker will guide the development and production of the intervention, which will be delivered in churches.