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A Community-Engaged Stroke Preparedness Intervention in Chicago.

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A community stroke preparedness intervention did not increase early hospital arrival or emergency medical services (EMS) use for confirmed strokes. However, ambulance transports for suspected strokes rose in the intervention area.

Keywords:
acute strokeeducation campaignsemergency medical services

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Area of Science:

  • Public Health
  • Neurology
  • Emergency Medicine

Background:

  • Stroke preparedness interventions aim to improve patient outcomes by increasing timely hospital arrival and emergency medical services (EMS) utilization.
  • Evaluating such interventions in diverse urban settings is crucial for understanding their effectiveness.

Purpose of the Study:

  • To assess the impact of a community-engaged stroke preparedness intervention on early hospital arrival and EMS utilization for stroke patients.
  • To compare changes in stroke care metrics in an intervention area with control sites.

Main Methods:

  • A quasi-experimental design compared pre- and post-intervention data from an intervention hospital in Chicago's South Side with control hospitals in Chicago's North Side and St. Louis.
  • Data included confirmed ischemic stroke cases (n=21,497) and EMS utilization for suspected strokes analyzed using geospatial information systems.
  • Key metrics were early hospital arrival (<3 hours) and EMS utilization rates.

Main Results:

  • Early hospital arrival rates for confirmed ischemic stroke did not significantly increase at the intervention hospital compared to control sites.
  • EMS utilization for confirmed ischemic stroke decreased slightly at the intervention hospital, with no significant difference compared to controls.
  • Ambulance transports for suspected strokes significantly increased in the intervention community and surrounding areas, but not in the control area.

Conclusions:

  • The community stroke preparedness intervention did not achieve its primary goals of increasing early hospital arrival or EMS use for confirmed strokes.
  • The intervention showed a positive effect on ambulance transports for suspected strokes, suggesting increased community awareness or response to stroke symptoms.
  • Further research is needed to understand the nuances of community engagement in stroke preparedness and its impact on different aspects of emergency care.