Stroke Recognition Tools for Spanish-Speaking Consumers: A Nationwide Study

Area of Science:

• Public Health
• Neurology
• Health Communication

Background:

• Stroke disproportionately affects Spanish-speaking Hispanic and Latino (SSHL) adults in the US, highlighting disparities in culturally appropriate health education.
• Existing stroke recognition acronyms in Spanish require evaluation for effectiveness and cultural relevance among SSHL adults.

Purpose of the Study:

• To evaluate the effectiveness of novel Spanish-language stroke recognition acronyms (AHORA, PARA Stroke, RÁPIDO) compared to usual care in improving stroke knowledge and intent to call 9-1-1 among SSHL adults.
• To assess preferences for stroke recognition acronyms among SSHL adults and healthcare professionals.

Main Methods:

• A 3-phase exploratory sequential design was employed, including interviews with healthcare professionals and focus groups with SSHL individuals.
• Phase 3 involved a randomized study with 1105 SSHL participants exposed to one of four interventions: AHORA, PARA Stroke, RÁPIDO, or usual care.
• Stroke knowledge and intent to call 9-1-1 were assessed pre- and 30-days post-exposure using online questionnaires, with data analyzed via ordinal and binomial regression.

Main Results:

• At 30 days, AHORA, PARA Stroke, and RÁPIDO showed comparable odds of recognizing stroke signs versus usual care (ORs ranging from 0.54 to 1.47, P>0.05).
• Intent to call 9-1-1 did not significantly differ between acronym groups and usual care (ORs ranging from 0.95 to 1.18, P>0.05).
• All acronyms demonstrated significant long-term positive effects on the intent to call 9-1-1, though no significant differences were found between the acronyms themselves.

Conclusions:

• The evaluated Spanish stroke recognition acronyms (AHORA, PARA Stroke, RÁPIDO) performed comparably to usual care in improving stroke recognition and intent to call 9-1-1.
• Healthcare professionals and SSHL consumers expressed a preference for culturally relevant Spanish-language acronyms, particularly RÁPIDO and PARA Stroke, over direct English translations.