Knowledge and Attitude Related to Stroke and Factors Associated with them Among Adults Aged 18 Years and Above in Kerala, India: A Community-Based Cross-Sectional Study

Abstract Background and Objectives: Data on community-level knowledge and attitudes toward stroke are limited in India, particularly in Kerala. This study assessed knowledge and attitudes toward stroke and identified associated factors among adults aged ≥18 years in Kerala. Methods: In this community-based cross-sectional study, 576 adults (mean age: 43 years; 44% male) were selected through multistage cluster sampling. Data on stroke knowledge and attitudes were collected using a pretested structured interview schedule. Log-binomial regression was used to determine factors associated with higher knowledge and positive attitudes. Results: Overall, 53.3% identified the brain as the organ affected by stroke, and 26.6% correctly recognized the treatment window (<4.5 hours). High knowledge was observed in 48.9% of participants and was significantly associated with older age ( P < 0.001), female sex ( P = 0.014), urban residence ( P < 0.001), college education ( P = 0.022), health insurance ( P = 0.002), family history of stroke ( P = 0.025), and receiving information from academic sources ( P = 0.015) or interpersonal communication ( P < 0.001). A positive attitude was reported by 44.4% and was more common among females ( P = 0.016), rural residents ( P = 0.030), college-educated adults ( P = 0.022), people with a family history of stroke ( P = 0.007), and those informed through academic sources ( P = 0.028). Conclusions: Key gaps persisted in recognizing stroke symptoms and the treatment window. Knowledge and attitudes were better among females and educated individuals, highlighting the need for targeted education in this population.