A stroke preparedness assessment instrument

描述（由申请人提供）：在美国，每年有近80万人患中风，每年中风的费用达到1050亿美元。中风也是美国残疾的主要原因。接受组织纤溶酶原激活剂（tPA）治疗的患者中风后残疾显著减少。对于临床有效性，tPA必须在卒中症状开始后4.5小时内给药。不幸的是，tPA的利用率极低，约有3%的中风患者接受tPA治疗。大多数患者未能接受tPA，因为他们在治疗时间窗过后到达医院（这种tPA给药的障碍称为院前延迟）。研究表明，如果在中风发作时拨打911，超过28%的中风患者将接受tPA治疗。因此，迫切需要进行转化研究以提高中风准备（定义为识别中风警告信号并立即拨打911的能力）。然而，由于缺乏中间终点来测试行为干预，中风准备领域受到严重限制。在进行大规模、昂贵的社区干预试验之前，需要进行使用中间终点的2期研究。中间终点允许在决定最有希望的干预措施之前测试几种干预措施（2期研究），以保证3期测试。中间终点也有助于对选定人群进行干预措施的测试，例如少数民族/种族或社会经济地位低的高危人群，而不是整个社区。在这个项目中，我们将开发和验证一个心理测量严格的测试中风准备使用视频小插曲-视频中风行动测试（video-STAT）。由于非裔美国人、西班牙裔美国人和社会经济地位较低的人群中风负担增加，我们将在开发和验证视频统计数据时从这些人群中过度采样。在本研究完成时，将创建一个创新的卒中准备中间终点，并执行验证它的关键步骤。随着美国人口老龄化，中风只会导致更多的受害者，并为个人，家庭和社会带来更大的代价。我们必须迅速发展 严格的科学干预措施，增加急性中风治疗的提供，以减少中风后残疾和减少这种毁灭性疾病的巨大影响。

DESCRIPTION (provided by applicant): Nearly 800,000 people suffer a stroke each year in the US and the cost of stroke reaches $105 billion annually. Stroke is also a leading cause of disability in the US. Post-stroke disability is dramatically reduced among patients who receive tissue plasminogen activator (tPA). For clinical effectiveness, tPA must be administered within 4.5 hours from the start of stroke symptoms. Unfortunately, tPA is vastly underutilized with about 3% of stroke patients receiving tPA. The majority of patients fail to receive tPA because they arrive to the hospital after the treatment time window has elapsed (this barrier to tPA administration is known as prehospital delay). Researchers have shown that if 911 were called at the time of stroke onset, over 28% of all stroke patients would receive tPA. Therefore, translational research to increase stroke preparedness (defined as the ability to recognize stroke warning signs and call 911 immediately) is urgently needed. However, the field of stroke preparedness is severely limited by the absence of intermediate end points to test behavioral interventions. Before embarking on large scale, expensive, community intervention trials, phase 2 studies using intermediate end points are needed. An intermediate end point allows for testing of several interventions (phase 2 studies) before deciding on the most promising intervention that warrants phase 3 testing. Intermediate end points also facilitate testing interventions for selected populations such as high risk groups like racial/ethnic minorities or those with low socioeconomic status, rather than an entire community. In this project, we will develop and validate a psychometrically rigorous test of stroke preparedness using video vignettes - the video stroke action test (video-STAT). Because of the increased burden of stroke among African Americans, Hispanics and those with low socioeconomic status, we will oversample from these groups in development and validating of the video-STAT. At completion of this study, an innovative stroke preparedness intermediate end point will be created and critical steps toward validating it will be performed. As the US population ages, stroke will only claim more victims and at greater expense to individuals, families and society. It is critical that we rapidly develop rigorous scientific interventions that increase delivery of acute stroke therapy to decrease post-stroke disability and reduce the enormous impact of this devastating disease.