SWIFT: Stroke Warning Information and Faster Treatment

急性缺血性卒中的快速诊断和治疗对于降低卒中相关疾病的发病率、致残率和死亡率至关重要。虽然静脉注射rt-PA是唯一被批准的治疗急性缺血性中风的方法，但只有不到2%-3%的合格患者接受了治疗。Rt-PA利用不足的原因有很多。最重要的是无法在症状出现后三小时内捕捉到急性缺血性中风病例。中风风险最高的人群在中风症状出现后立即进行快速紧急干预的必要性仍然严重缺乏教育。在包括非裔美国人、拉美裔美国人和穷人在内的弱势群体中尤其如此。我们的主要目标是确定一个名为SWIFT(中风警告信息和快速治疗)的三节课文化敏感互动教育计划是否比在种族和民族多样化的高危人群中进行常规护理更有效。干预的目标是增加对中风的认识，改变行为，并在出现中风症状时改善到达急诊室的时间。为了实现这些目标，我们计划将1400名中风/短暂性脑缺血发作患者和1200名无中风社区居民随机分为SWIFT干预组和常规护理组。所有参与者将在干预前和干预后(30天和1年)接受卒中知识/行为调查。全面的监测方法将在研究期间测量研究参与者中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；给予获得紧急医疗救治的紧迫感；以及帮助导航紧急护理将提高中风意识，并减少个体对救命中风治疗的反应时间。

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.