Abstract TP211: Sign-Specific Variations in Public Knowledge of Stroke Warning Signs and Demographic Influences Upon Post-Education Retention

Background: Delayed patient/witness activation of the 911 system delays stroke patient arrival. Community stroke education is critical in reducing these delays. The Face-Arm-Speech-Time (FAST) mnemonic has been the AHA/ASA's stroke symptom public education message since 2013. A more inclusive mnemonic that adds Balance-Eyes (BEFAST) has been proposed that increases the mnemonic’s scope but may be harder to recall. The objective of this study was to delineate sign-specific variations in public awareness and determinants of retained sign knowledge after an educational intervention. Methods: This is a secondary analysis of a randomized trial comparing use of FAST vs BEFAST as the basis of a comprehensive stroke education intervention. The initial study used an infographic summarizing the definition of a stroke, common modifiable risk factors, possible outcomes, and either the FAST or BEFAST mnemonics with illustrative symptoms. Retention was assessed at 14-21 days. Results: Among 50 enrolled adults, mean age was 37.2±14.8 and 60% were female (Table 1). At baseline prior to the study education intervention, 23 (46%) participants knew the definition of stroke and participants could describe a mean 1.60 signs, 0.98 risk factors, and 0.74 outcomes. The sign-specific frequencies of awareness at baseline are shown in Figure 1. Arm weakness was most common, listed by 52%, followed by face asymmetry at 42%. Speech difficulty, balance difficulty, and the importance of time were known by 20-28% of individuals. Visual disturbances were least well known, listed by only 6% of participants. Participant knowledge of stroke signs improved from Meeting 1 to 2 in both the FAST (2.0 to 3.0 signs, P<0.01) and BEFAST (1.2 to 2.4 signs, P<0.01) groups. Post-education warning sign retention was not modified by participant age, sex, education level, or employment status (Table 2). Discussion: In this randomized trial, baseline public awareness of stroke warning signs was suboptimal, with arm weakness known by a little more than half, most other signs known only by about one-quarter, and few aware of visual disturbance. The mnemonic-based education programs assessed in the study showed efficacy across sex, age, education, and employment status groups, supporting further testing in a pivotal trial.