Tailored Approaches to Stroke Health Education

中风是导致成年人残疾的主要原因，每年花费美国纳税人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可能会增加低发病率 接受溶栓治疗(目前全国平均比率为3%)。溶栓治疗会增加罹患 如果紧急医疗系统的反应时间和医院内反应时间最短，中风的残疾最小或为零 时间优化(从症状出现到静脉溶栓的最长时间为4.5小时)。黑色 与白人相比，拉美裔美国人的中风发病率更高，而且更不可能 急性卒中溶栓治疗。到达医院的潜伏期在很大程度上取决于患者对 中风症状，并立即出现在急诊科。我们小组发现了非常低的 与白人相比，黑人和西班牙裔的中风识字率，这可能是部分原因 急性卒中治疗中的差异。在我们之前工作的基础上，我们已经确定了 提高中风识字率和拨打911的行为意向，我们将制定和评估 一种小说，以两个人的形式使用讲故事(叙事说服)的文化定制干预 专业制作了12分钟的电影(英语和西班牙语)，在纽约市的少数族裔人口中。这部电影将会 (1)传达中风症状的知识；(2)传达中风症状的严重程度 可能会出现症状(例如，语音的轻微含糊应该足以促使行动)；(3) 传达拨打911的治疗益处，以及(4)克服自然不愿去急诊室， 如果症状并不严重，与否认或尴尬有关的障碍。跨学科的 由当地黑人和西班牙裔教堂的社区成员组成的团队，中风专家，行为 科学家包括叙事传播专家、知识获取理论专家和 专业电影制作人将指导干预的开发和制作，并将交付 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.