Bell Mindy, Lommel Tiffany, Fischer Joan G, Lee Jung Sun, Reddy Sudha, Johnson Mary Ann
University of Georgia, Athens, GA 30602, USA.
Prev Chronic Dis. 2009 Apr;6(2):A41. Epub 2009 Mar 16.
In Georgia, mortality from stroke is 16% higher and from cardiovascular disease is 9% higher than it is nationally. Although 75% of Georgia adults have 2 or more modifiable risk factors for cardiovascular disease, less than half recognize all major heart attack and stroke warning symptoms. To reduce disability and prevent death from cardiovascular events, high-risk population groups should be able to recognize symptoms and seek immediate medical attention.
We evaluated a 4-month education intervention in 40 senior centers in Georgia. The intervention focused on improving knowledge of heart attack and stroke symptoms and on promoting lifestyle behaviors that prevent and manage cardiovascular disease and diabetes. Participants in a convenience sample completed a pretest questionnaire, the intervention, and a posttest questionnaire (N = 693, mean age, 75 years, 84% female, 45% black).
After the intervention, recognition of all 5 symptoms of heart attack increased from 29% at the pretest to 46% at the posttest, and recognition of all 5 symptoms of stroke increased from 42% at the pretest to 65% at the posttest (for both conditions, P < .001). In linear regression analyses, independent positive predictors of change in knowledge were younger age and higher education. Most risk factors for cardiovascular disease were not predictive.
The results of this evaluation provide an evidence base for the effectiveness of this intervention in improving knowledge about heart attack and stroke symptoms, which may translate to greater preparedness in these older adults for response to cardiovascular events.
在佐治亚州,中风死亡率比全国水平高16%,心血管疾病死亡率比全国水平高9%。尽管75%的佐治亚州成年人有2种或更多可改变的心血管疾病风险因素,但不到一半的人能识别出所有主要的心脏病发作和中风警示症状。为了减少残疾并预防心血管事件导致的死亡,高危人群应能够识别症状并立即寻求医疗救助。
我们在佐治亚州的40个老年中心评估了一项为期4个月的教育干预措施。该干预措施侧重于提高对心脏病发作和中风症状的认识,并促进预防和管理心血管疾病及糖尿病的生活方式行为。便利样本中的参与者完成了一份预测试问卷、干预措施以及一份后测试问卷(N = 693,平均年龄75岁,84%为女性,45%为黑人)。
干预后,对所有5种心脏病发作症状的识别率从预测试时的29%提高到了后测试时的46%,对所有5种中风症状的识别率从预测试时的42%提高到了后测试时的65%(两种情况P均<.001)。在线性回归分析中,知识变化的独立正向预测因素是年龄较小和教育程度较高。大多数心血管疾病风险因素并无预测作用。
本次评估结果为该干预措施在提高对心脏病发作和中风症状的认识方面的有效性提供了证据基础,这可能会使这些老年人在应对心血管事件时更有准备。