SWIFT: Stroke Warning Information and Faster Treatment

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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.