Changing the strategy and culture of stroke awareness education in China: implementing Stroke 1-2-0.

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.