Factors contributing to awareness of the necessity to call 9-1-1 for stroke symptoms in residents from Upstate, New York

Early treatment for stroke improves the chance of survival and recovery. This study identifies factors associated with a person's intent to call 9-1-1 in response to identifying a stroke symptom in themselves or another. A total of 1789 English speaking respondents' ages 30+ from Upstate, NY completed a list-assisted RDD telephone survey during Summer 2006.

Delaying care in the past was consistently associated with decreased odds of intention to call 9-1-1 for four stroke symptoms after controlling for demographics, previous heart event, and insurance coverage. Respondents who reported delaying care had decreased odds of reporting that they would call 9-1-1 if they were speaking incorrectly (OR: 0.77, 95% CI: 0.62-0.95), had vision problems (OR: 0.68, 95% CI: 0.53-0.88), or sudden arm weakness (OR: 0.65, 95% CI: 0.52-0.85). The odds of intent to call 9-1-1 for the same symptoms in another were 0.70 (95% CI: 0.57-0.88), 0.66 (95% CI: 0.52-0.84), 0.78 (95% CI: 0.63-0.96). The odds of intent to call 9-1-1 if another person's face was uneven were 0.83 (95% CI: 0.67-1.04) if the respondent had delayed care. About 69% did not recognize vision problems and 29% did not recognize speaking unclearly as necessitating calling 9-1-1.

This study has implications for educational campaigns to promote seeking care to avoid delay in stroke treatment. The discrepancy in identifying different stroke symptoms as necessitating emergency response and a general tendency to delay health care suggests a need to target education towards increasing awareness of specific symptoms, their seriousness, and importance of immediate care.