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Original research
Changing the strategy and culture of stroke awareness education in China: implementing Stroke 1-2-0
  1. Jing Zhao1,2,
  2. Xutong Li1,
  3. Xiaochuan Liu3,
  4. Yuming Xu4,
  5. Jihong Xu5,
  6. Anding Xu6,
  7. Yongjun Wang7,8,
  8. Renyu Liu5
  1. 1 Neurology, Minhang Hospital, Fudan University, Shanghai, China
  2. 2 Department of Neurology, Fudan University, Shanghai, China
  3. 3 Wannan Medical College, Wuhu, China
  4. 4 Zhengzhou University First Affiliated Hospital, Zhengzhou, China
  5. 5 Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  6. 6 Department of Neurology and Stroke Center, Jinan University First Affiliated Hospital, Guangzhou, China
  7. 7 China National Clinical Research Center for Neurological Disease, Beijing, China
  8. 8 Neurology, Tiantan Hospital Affiliated to Capital Medical University, Beijing, China
  1. Correspondence to Dr Renyu Liu; renyu.liu{at}pennmedicine.upenn.edu

Abstract

This project implemented the Stroke 1-2-0 stroke awareness programme across China and investigated its impact over a 2-year period. We initiated the Stroke 1-2-0 educational campaign and Stroke 1-2-0 special task forces (STF) across the nation. Massive media coverage, community-based educational sessions with videos and other related materials and induction of Stroke 1-2-0 STF were the major means of promotion. We delivered a survey at the end of 2016 and 2018 to evaluate the impact of our effort. A total of 3066 participants responded to the first survey in 2016, and 15 207 participants responded in 2018 across China. The acceptance rate for Stroke 1-2-0 versus FAST (an English-language stroke awareness tool) was 50.2% versus 19.1% in 2016, and changed significantly to 82.2% versus 8.0% in 2018 (p<0.001). Stroke 1-2-0 was well accepted by all ages and by people with different academic qualifications. Only 6.5% of survey respondents were aware that there was a therapeutic window for thrombolytic therapy in 2016, but this awareness increased significantly to 32.8% in 2018. Only 12.6% of people in 2016 indicated that they would send patients with stroke to the nearest hospital capable of performing thrombolytic therapy, but there was a nearly threefold increase (52.5%) in this number by 2018. More than 1000 major hospitals joined the Stroke 1-2-0 STF, and more than 20 000 ‘stroke warriors’ have joined our stroke awareness improvement effort so far. Stroke 1-2-0 stroke awareness programme is well-implemented and accepted, and is generating profound improvement in stroke awareness in China.

  • education
  • pre-hospital delay
  • stroke
  • thrombolytic therapy
  • therapeutic window
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/svn-2019-000324

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    Footnotes

    • Contributors JZ and RL participated in designing the study, collecting data, analysing the data and writing the paper; the rest of the team participated in collecting data, analysing the data and writing the paper.

    • Funding We appreciate the following funding support from the National Natural Science Foundation of China (81572232, PI: JZ); Shanghai Natural Science Foundation (17dz2308400, PI: JZ); China Research Engagement Funding of the University of Pennsylvania (CREF-030, PI: RL).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study protocol was approved by the Institutional Review Board of Minhang Hospital, affiliated to Fudan University.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Data are available upon reasonable request to Dr Jing Zhao, the first author of this paper.