Stroke Literacy Video for Patients and Families: Symptoms, Risk Factors, and Prevention

BACKGROUND: Most vascular events after stroke may be prevented by modifying vascular risk factors through medical and behavioral interventions. Stroke literacy, an understanding of stroke symptoms, risk factors, and treatment, likely contributes to vascular risk factor control and in turn stroke recurrence risk. Stroke literacy among U.S. adults is lowest among racial and ethnic minority populations. Video-based interventions targeting stroke literacy may help acute stroke survivors understand stroke and subsequently reduce stroke recurrence. However, failure of prior stroke literacy interventions may be due in part to the fact that the interventions were not theory driven. Intervention mapping provides a framework to use in the development, implementation, and evaluation of evidence-informed health-related interventions.

OBJECTIVE: To develop a video-based educational intervention to improve stroke literacy in hospitalized acute stroke patients.

METHODS: The 6-step iterative process of Intervention Mapping (IM) was used to develop a video-based educational intervention and related implementation and evaluation plans. The six steps include a needs assessment, identification of outcomes and change objectives, selection of theory- and video-based intervention methods and practical applications, development of a video-based stroke educational intervention, plans for implementation, and evaluation strategies.

RESULTS: A 5-minute video-based educational intervention was developed. The intervention mapping approach led to successful intervention development by emphasizing stakeholder involvement, generation and adoption, and information retainment in the planning phase of the intervention. A planned approach to video adoption, implementation, and evaluation was also developed.

CONCLUSIONS: An intervention mapping approach guided the development of a 5-minute video-based educational intervention to promote stroke literacy among acute stroke survivors. Future studies are needed to assess the use of technology and digital media to support wide-spread access and participation in video-based health literacy interventions for the acute and chronic stroke populations. Studies are needed to assess the impact of video-based educational interventions paired with stroke systems of care optimization to promote stroke recurrence risk reduction. Furthermore, studies of culturally and linguistically sensitive video-based stroke literacy interventions are needed to address known racial and ethnic disparities in stroke literacy.

INTERNATIONAL REGISTERED REPORT: RR2-https://doi.org/10.1371/journal.pone.0171952.