The Challenges of Community-Based Research

Abstract

Background and Purpose— Public knowledge of stroke warning signs and risk factors is poor, especially in higher risk groups such as blacks. We sought to design a creative new way to educate black women by working through local beauty salons and measuring the results of the intervention. Methods— Thirty black beauticians were educated about stroke warning signs and risk factors in 2 large urban areas in the US. The beauticians then educated their clientele during appointments. Stroke knowledge gained was measured via de-identified pre- and post-intervention (at 6 weeks and 5 months) surveys that included open-ended questions. Stroke warning signs were taught using the “FAST” (Face, Arm, Speech, Time) method. Results— There were 383 completed baseline surveys, and 318 surveys were completed at 5 months. Of the 383 women, 78% were <60 years old, 69% had some college education, 41% had hypertension, and 12% had diabetes. The percentage of women who knew 3 warning signs significantly improved from the baseline survey (40.7%) to the final survey (50.6%), and similar improvements in knowledge were seen in both study regions. There was no improvement in knowledge of 3 risk factors (16.5% versus 18.2%). After our educational intervention, 94% knew to call 911 for stroke symptoms, an 8% improvement over baseline ( P =0.002). Conclusions— Despite the challenges of community-based research encountered within our project, we found that stroke education in the beauty shop significantly improved knowledge regarding stroke warning signs and calling 911 among a group of black women. This improvement in knowledge was sustained for at least 5 months. Knowledge of stroke risk factors, however, did not improve. The use of the beauty shop as an educational site is a novel approach to stroke education for women that can be practically applied in the community. Education regarding stroke risk factors remains a challenge that warrants further study.