Community Engagement for Early Recognition and Immediate Action in Stroke

The CEERIAS community-partnered research project has the following specific aims:

1. To examine personal, community, and cultural barriers to calling 911 after stroke onset
and adapt a culturally-tailored intervention for delivery in multi-ethnic communities
(African American, Hispanic, non-Hispanic White) surrounding 2 hospitals on the south
side of Chicago;

2. To implement a culturally-adapted stroke awareness and action program and monitor its
penetration and adoption using the RE-AIM (Reach, Evaluate, Adoption, Implementation,
Maintenance) framework in 2 multi-ethnic communities on the south side of Chicago; and

3. To assess change in early hospital arrival and EMS use at 2 intervention hospitals
before and after the community intervention.

For aim 1, the investigators will explore and identify facilitators and barriers to calling
911 for stroke through focus groups conducted and involving key stakeholders including
children and adults, stroke survivors, neighborhood alderman/legislators, spiritual and
community leaders, school teachers, and stroke advocacy group members. The CEERIAS team will
test and culturally refine our core community-partnered pilot intervention for
implementation.

For aim 2, the investigators will identify and train Stroke Promoters from collaborating
community organizations on the adapted intervention techniques and messages, provide
materials for public dissemination, and evaluate and monitor adoption and implementation in
the surrounding communities.

For aim 3, the investigators will perform an interrupted time-series analysis of EMS use and
early hospital arrival among stroke patients before and after our intervention in 2 south
side Chicago communities. The research team will also compare time trends in EMS use and
early hospital arrival for stroke with control PSCs on the north and west sides of Chicago
and PSCs in St. Louis.

If the intervention is successful, the effect will be an increase in EMS use for stroke
which will translate into earlier treatment for stroke and reduced death and disability. The
CEERIAS results will be generalizable to other urban communities in the US and should be
salient to other health emergencies such as heart attack and cardiac arrest.

Inclusion Criteria:

- Adults 18 years of age or older

- Hispanic, African American, or Caucasian/White

- Reside within the following Chicago Zip Codes: 60617, 60619, 60620, 60621, 60628,
60629, 06032, 60639, or 60649

Exclusion Criteria:

- < 18 years old

- Ethnic groups outside our targeted population

- Outside targeted catchment area