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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
A randomized, controlled trial to teach middle school children to recognize stroke and call 911: the kids identifying
Lewis B Morgenstern1, Nicole R Gonzales, Katherine E Maddox
1Stroke Program, University of Michigan Health System, 1500 E Medical Center Dr, TC 1920/0316, Ann Arbor, MI 48109-0316, USA. LMorgens@umich.edu
Insights
Educating middle school students about stroke symptoms and emergency response significantly increased their likelihood to call 911. This pilot study shows potential for improving stroke care access through early education.
Area of Science:
- Public Health
- Pediatric Education
- Emergency Medicine
Background:
- Acute stroke therapy utilization is limited by delayed hospital arrival.
- Prompt medical attention is crucial for effective stroke treatment outcomes.
Purpose of the Study:
- To evaluate an educational intervention aimed at increasing 911 calls for stroke among middle school students.
- To assess the impact of this intervention on stroke knowledge and intended emergency response behaviors.
Main Methods:
- A pilot randomized controlled trial was conducted in Corpus Christi, Texas.
- Intervention involved 12 hours of classroom instruction for 6th, 7th, and 8th graders.
- Parents were indirectly engaged through homework assignments; statistical analysis used two-sample t tests.
Main Results:
- Intervention students showed significant improvements in stroke pathophysiology (29% to 34%), symptom knowledge (28% to 43%), and intended actions (36% to 54%).
- Control students demonstrated minimal changes in these domains.
- Statistical significance (P<0.001) was achieved for all domains between groups.
Conclusions:
- A theory-based educational program can enhance middle school students' intent to call 911 for stroke.
- Alternative strategies are required for effective parental engagement and curriculum dissemination.
Background And Purpose:
Underutilization of acute stroke therapy is driven by delay to hospital arrival. We present the primary results of a pilot, randomized, controlled trial to encourage calling 911 for witnessed stroke among middle school children and their parents.
Methods:
This project occurred in Corpus Christi, an urban Texas community of 325,000. Three intervention and 3 control schools were randomly selected. The intervention contained 12 hours of classroom instruction divided among sixth, seventh, and eighth grades. Parents were educated indirectly through homework assignments. Two-sample t tests were used to compare pretest and posttest responses.
Results:
Domain 1 test questions involved stroke pathophysiology. Intervention students improved from 29% to 34% correct; control students changed from 28% to 25%. Domain 2 test questions involved stroke symptom knowledge. Intervention school students changed from 28% correct to 43%; control school students answered 25% correctly on the pretest and 29% on the posttest. Domain 3 test questions involved what to do for witnessed stroke. Intervention school students answered 36% of questions correctly on the pretest and 54% correctly on the posttest, whereas control students changed from 32% correct to 34%. A comparison of change in the mean proportion correct over time between intervention and control students was P<0.001 for each of the 3 individual domains. A poor parental response rate impaired the ability to assess parental improvement.
Conclusions:
A scientific, theory-based, educational intervention can potentially improve intent to call 911 for stroke among middle school children. A different mechanism is needed to effectively diffuse the curriculum to parents.
