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See Latest ArticlesThe Impact of the Extended Parallel Process Model on Stroke Awareness. Pilot Results From a Novel Study
Stroke, 10/08/09
Davis SM et al. – A common stroke education poster modified according to the Extended Parallel Process model did not significantly increase stroke knowledge compared with a standard control. However, the Extended Parallel Process model may promote long–term stroke knowledge retention, although further studies are needed due to insufficient power from subject attrition.
Stephen M. Davis, 10/09/09
| Despite being the number one cause of long term disability in adults in the United States, 9 out of 10 stroke victims fail to receive life saving and disability reversing thrombolytic treatment, largely due to emergency department presentation outside of the various thrombolytic treatment time windows. The largest part of this delay occurs in the prehospital setting, with the majority likely attributable to a lack of public awareness of both the signs and symptoms of stroke AND the need to seek immediate treatment by calling 911. It is notable that this presentation delay has persisted since the inception of thrombolytic therapy despite the creation of well crafted messages by large organizations such as the American Stroke Association and the National Institute of Neurological Disorders and Stroke. Part of this phenomenon is necessarily due to the fact that existing stroke messages must be delivered in a recurring basis over a long period of time to prevent memory decay, which can be quite costly to many locales. However, it is also possible that the messages themselves can be strengthened using well grounded scientific theories to promote both acquisition and long term retention of stroke knowledge. Taking this approach, we used one empirically tested health communications theory, extended parallel process, to modify a common stroke message by adding the constructs of perceived vulnerability (i.e., “I am a risk for having a stroke.”), self efficacy (i.e., “There is an easy action I can take to minimize this risk (call 911).”), and treatment efficacy (i.e., “I must call 911 immediately to minimize this risk.”) to the message. The latter construct may be particularly important due to the fact that most strokes are painless, and thus create a sense of non-urgency in victims and their families during the onset of symptoms. Although we failed to find a significant difference between our modified poster and the traditional poster, we did notice a trend of decreased knowledge decay in the group exposed to our modified poster regardless of age. It is possible that the lack of statistical significance exhibited by this trend is due to a severe loss of study power at the 6 week follow-up measurement. Therefore, more studies are needed that not only incorporate the tenants of the extended parallel process into existing messages, but also use other theoretically derived and empirically tested modalities to modify existing messages (or even create new ones). Our end result is to create a message (or messages) that contribute to earlier presentation for treatment and decrease not only mortality from stroke, but also the crushing long term disability that stroke survivors and their families suffer with the concomitant significant negative impact to societal economic productivity. |
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