Web-based stroke education for patients and families

描述（由申请人提供）：缺血性卒中是美国的主要疾病来源和负担，卒中幸存者复发风险高，因此他们是二级预防的重要群体。然而，脑卒中幸存者存在三大知识空白，这是脑卒中后有效干预的障碍：对脑卒中早期预警信号的认识不足，对康复目的和目标的认识不足，以及对个人危险因素的认识不足。卒中教育中的这些知识差距导致卒中管理和卒中相关发病率预防不理想。在治疗中风患者的各种卫生保健环境（如医疗康复）中，这种教育没有得到充分重视。我们建议，一个有效的教育项目，解决卒中幸存者知识的这些差距，将通过促进康复、降低再次卒中的风险和降低复发性卒中的发病率来改善卒中的预后。第一阶段SBIR应用旨在为中风幸存者及其家属建立基于网络的教育的可行性。该提案将开发一个原型，以提供有关中风的知识，包括表现症状、危险因素和一个常见危险因素（高血压）的管理。中风幸存者表现出广泛的认知缺陷。为了适应这些有轻度和中度缺陷的病人，我们将利用各种多媒体格式和自我评估练习来探索“适应性学习”的方法。我们将召集从大型康复机构招募的中风患者及其护理人员的焦点小组。这些小组提供的关于基于网络的教育所需属性的信息将用于开发教育模块的内容和格式。然后，我们将开发一个包含两个内容模块的原型：关于中风的普通教育，包括风险因素、警告信号，以及如果怀疑中风该怎么做；还有一个关于高血压的模块，包括解释什么是高血压，为什么它是中风的危险因素，以及如何最好地管理它（治疗依从性，生活方式等）。这些模块将以两种不同的呈现风格制作，以适应用户的缺陷，包括允许根据用户的认知能力进行重复和强化的特征。该计划将包括自我评估工具，以确定用户的学习需求。在原型开发完成后，另一组患者和家属将提供满意度数据和定性反馈。基于第一阶段的反馈，第二阶段将开发一个基于网络的项目，解决所有主要可管理的风险因素、一般中风知识和对中风康复的理解。对于中风医疗提供者来说，这将是一种有市场的产品，包括康复医院，这些医院必须满足特定的患者教育要求。此外，希望改善中风预防工作的保险公司可能是一个收入来源。

DESCRIPTION (provided by applicant): Ischemic stroke is a major source of illness and burden in the U.S. Stroke survivors are at high risk for recurrence, and therefore they are an important group for secondary prevention. However, there are three major gaps of knowledge in stroke survivors that are obstacles to effective intervention following stroke: inadequate knowledge of the early warning signs of stroke, inadequate understanding of the purpose and goals of rehabilitation, and lack of awareness of personal risk factors. These knowledge gaps in stroke education lead to suboptimal management of stroke and suboptimal prevention of stroke-related morbidity. This education is not adequately addressed in the various health care environments that treat stroke patients (such as medical rehabilitation). We propose that an effective program of education that addresses these gaps in stroke survivors' knowledge would improve stroke outcomes by promoting rehabilitation, reducing the risk of another stroke, and reducing morbidity of recurrent strokes. This Phase I SBIR application is to establish the feasibility of web-based education for stroke survivors and their families. The proposal will develop a prototype to provide knowledge about stroke, including presenting symptoms, risk factors, and management of one common risk factor (hypertension). Stroke survivors present with a wide range of cognitive deficits. To accommodate some of these patients with mild- moderate deficits, methods of "adaptive learning" will be explored using various multi-media formats and self-assessment exercises. We will convene focus groups of stroke patients and their caregivers recruited from a large rehabilitation facility. Information from these groups regarding the desired attributes of a web-based education will be used to develop the content and format of the educational modules. We will then develop a prototype with two content modules: a general education about stroke, including risk factors, warning signs, and what to do if a stroke is suspected; and a module focused on hypertension, including an explanation of what hypertension is, why it is a risk factor for stroke, and how to best manage it (treatment compliance, life-style, etc.). These modules will be produced in two different presentation styles to adapt to the users' deficits, including features that will permit repetition and reinforcement according to the cognitive abilities of the users. The program will include self-assessment tools to identify users' learning needs. After the development of the prototype, another group of patients and families will provide satisfaction data and qualitative feedback. Based on the Phase I feedback, the Phase II will develop a web-based program that addresses all of the main manageable risk factors, general stroke knowledge, and an understanding of stroke rehabilitation. This will be a marketable product to providers of medical treatment for stroke, including rehabilitation hospitals which must meet specific patient education requirements. Additionally, insurance companies that wish to improve stroke prevention efforts could be a source of revenue.