Hip Hop Stroke: Developing a framework of child-mediated communication to address stroke literacy

Low thrombolysis rates for stroke have been linked to stroke literacy barriers to early arrival. We developed a stroke literacy intervention to improve knowledge of common risk factors, stroke symptoms, time-dependent stroke treatment, appropriate action when symptoms occur, and prevention measures.

Hip Hop Stroke (HHS) uses hip hop music and child-centric media (cartoons, video games, comic books) to improve stroke literacy of 4^th–6^thgrade students in high-risk minority communities. Homework activities designed to be fun, serve as a child-mediated channel to improve parental stroke literacy, which we have demonstrated in prior studies. The intervention has also resulted in several reported cases of HHS-educated children calling 911 for stroke occurrences in their homes.

Using constructs from the Health Belief Model and Theory of Reasoned Action, we developed a framework of child-mediated communication to explain how our approach addresses stroke literacy, with a focus on stroke recognition and action. We illustrate the mediating influence of self-efficacy, attitudes, perceived severity, perceived susceptibility, and perceived barriers between knowledge gain in children and the transfer of this knowledge to parents, as well as translation of knowledge into behavioral intent and action by children and parents (i.e., calling 911 for acute stroke symptoms). We also illustrate the important moderating influence of parenting style, emotional appeal, source trustworthiness, SES, medical mistrust and health literacy on child-mediated communication.

Our child-mediated health communication framework elucidates the potential role of children as conduits of critical health knowledge to their parents, which in our case is stroke literacy.