Study reveals low stroke awareness

03 Sep, 2020
Study reveals low stroke awareness

A national survey shows that stroke is not recognised as a major cause of death. It also reveals low-level awareness of stroke among Pacific peoples.

A random sample of 400 adults participated in the national telephone survey.

When asked to identify the most common cause of death, participants named heart disease (37 percent) and cancer (33 percent). Only 1.5 percent of those surveyed named stroke as a common cause of death.

“The recognition of stroke as a common cause of death was low, well below heart disease and cancer. This may be due to low level awareness of stroke as a cause of death in general, and to the higher profile of heart disease and cancer in the media, screening and fundraising campaigns,” says Associate Professor Rita Krishnamurthi, Deputy Director of the National Institute of Stroke and Applied Neurosciences at AUT.

“Our findings suggest that public health messages on the importance of modifiable stroke risk factors need to be significantly enhanced, particularly around blood pressure control for stroke prevention.”

Associate Professor Krishnamurthi is the lead author of the study, Community Knowledge and Awareness of Stroke in New Zealand, published in the Journal of Stroke and Cerebrovascular Diseases. Funding was provided by Brain Research New Zealand.

The researchers found that being more educated and having a higher income are associated with higher stroke awareness. Personal experience of stroke also contributed to better knowledge and awareness overall.

This is the first national stroke awareness survey with an ethically stratified sample – almost equal representation of New Zealand’s four major ethnic groups; European, Māori, and Pacific peoples (25-33 percent); and Asian (14 percent).

The findings reveal that Pacific peoples had the lowest level of stroke awareness. Pacific peoples identified fewer stroke symptoms and were 58 percent less likely to correctly identify stroke risk factors.

“Low stroke awareness, especially among Pacific peoples, needs to be addressed urgently. This is particularly important given the disproportionately high burden of stroke among Māori and Pacific peoples,” says Associate Professor Krishnamurthi.

Low functional health literacy is also associated with low stroke awareness, and English is commonly a second language among Pacific and Asian peoples.

“We need to develop language-specific, culturally tailored material and methods of delivering information to these communities. Training key staff in community groups to help educate members has the potential to increase access to and uptake of stroke information.”

According to a previous NISAN study, the incidence of stroke among Māori and Pacific peoples was 30-60 percent higher than Europeans, and they suffered strokes from a significantly younger age.

The same study also showed that the mortality rate of stroke among Pacific peoples was almost double that of Europeans. And, the prevalence of stroke risk factors, such as diabetes and smoking, was almost threefold higher among Māori and Pacific peoples, compared to Europeans.

The national survey was conducted in the absence of any major stroke awareness campaigns, allowing for testing of baseline awareness. It also compared two methods of questioning, which yielded very different results.

Researchers found that stroke awareness was high when participants were prompted with a list of possible responses. However, unprompted questioning resulted in lower awareness of stroke risk factors.

Only 30 percent of participants correctly identified two or more stroke risk factors without any prompting. There was a tenfold decrease in the proportion of people able to identify five stroke risk factors, compared to prompted responses.

Having a university level education was associated with a 75 percent greater number of people identifying stroke risk factors when unprompted, compared to those with up to high school level of education.

Participants from middle income households were almost twice as likely to correctly identify stroke risk factors, compared to low income households.