Stroke Literacy in Central Harlem: a High-risk Stroke Population

Background: Awareness of stroke warning symptoms and risk factors (stroke literacy), as well as knowledge of available treatment options, may be poor in high-risk populations. We sought to evaluate stroke literacy among residents of Central Harlem, a predominantly African American population, in a cross-sectional study.

Methods: Ten community-based sites in Central Harlem were identified between 2005 and 2006 for administration of a stroke knowledge survey. Trained volunteers administered in-person closed-ended questionnaires focused on stroke symptoms and risk factors.

Results: A total of 1,023 respondents completed the survey. African Americans comprised 65.7% (n = 672) of the survey cohort. The brain was correctly identified as the site where a stroke occurs by 53.7% of respondents, whereas the heart was incorrectly identified by 20.8%. Chest pain was identified as a symptom of stroke by 39.7%. In multivariable analyses, African Americans (odds ratio [OR] 2.20, 95% confidence interval [CI] 1.09-4.45) and Hispanics (OR 5.27, 95% CI 2.46-11.30) were less likely to identify the brain as the damaged organ in stroke. Hispanics were more likely to incorrectly identify chest pain as a stroke symptom, compared with whites (OR 3.40, 95% CI 1.49-7.77). No associations were found between calling 911 and race/ethnicity and stroke knowledge, although women were more likely than men to call 911 (OR 0.50, 95% CI 0.30-0.80).

Conclusion: Significant deficiencies in stroke literacy exist in this high-risk population, especially when compared with national means. Culturally tailored and sustainable educational campaigns should be tested in high-risk populations as part of stroke public health initiatives.