A three-hour multimedia stroke lesson featuring a hip-hop music video can improve stroke preparedness among economically disadvantaged, minority children and their parents, according to new research published in the journal Stroke on March 22.
Stroke is a leading cause of preventable long-term disability and affects almost 800,000 people in the United States each year, a disproportionate number of whom are African American and Hispanic, according to the US Centers for Disease Control and Prevention (CDC). The biggest determinant in getting optimal treatment is how quickly patients get to the emergency department after the first symptoms. The key to ensuring a timely arrival is recognizing the signs of a stroke.
Until now, stroke education efforts have been through mass media campaigns with limited reach in socioeconomically disadvantaged neighborhoods, and less focus on high-risk minority populations. Stroke education in schools is gaining traction as a way to target such high-risk populations. In addition, children often witness strokes and can call 911.
To find out if a culturally tailored multimedia intervention could educate children from high-need schools about stroke, and whether these children could then educate their parents, researchers at various institutions in New York studied 3,070 children in fourth to sixth grade from 22 New York City public schools, as well as 1,144 parents. Schools were randomized to watch a Hip-Hop Stroke (HSS) multimedia lesson or listen to information about nutrition.
The HHS intervention consisted of a hip-hop music video teaching the FAST (facial drooping, arm weakness, speech difficulty, and time to call emergency services) acronym to the beat of The Village People’s YMCA, two short animated cartoons, a stroke clot-buster video game, and a comic book. Accompanying homework encouraged children to share what they learned with parents.
To assess stroke preparedness in both children and parents, researchers administered a seven-item quiz with questions about stroke symptoms and willingness to call 911 given a description of a likely stroke scenario. Participants took the test before and after the intervention, as well as three months later to determine if they retained the information.
At the start of the trial, researchers found that only 2 percent or less of all children could correctly name all stroke symptoms and recognize a typical case. After the hip-hop stroke education, 57 percent of the children were able to. Three months later, 24 percent of these children still retained this knowledge.
Parents were similarly uneducated about stroke—only about 3 percent were able to name all four letters of the FAST acronym. After their children participated in the HHS intervention, this number increased to 20 percent, and remained at 17 percent three months later. In other words, for every 100 parents whose children were shown Hip-Hop Stroke, 14 additional parents passed the FAST literacy test with a perfect score.
Children educated through the hip-hop intervention were able to apply what they learned; during the study, four children called 911 for real strokes that happened at home. One child even overrode family members’ judgments to postpone calling for help.
These examples and the study as a whole are evidence that campaigns like the Hip-Hop Stroke program may be an effective way to deliver important public health messages to the communities where they will have the most impact. The multimedia resources used in Hip-Hop Stroke are available online.