Appendix 2.Characteristics ofthe 49 SK tests used in only 1 published study
Authors† / Year / Country / Developers / Purpose of the test / Methods of development / Tailored to target population / SK concepts / Administration method / No. of itemsDefinition / Epidemiology / Risk factors / Warning signs / Emergency response / Symptoms / Treatment/ rehabilitation
Adelman EE, et al.1 / 2014 / USA / NS / Evaluate SKamong inpatient and emergency department nursing staff / NS / NS / / Interview / 1 OEQ
Akiyama, H, et al.2 / 2013 / Japan / NS / Assess SK and TIA in general public / NS / NS / / Self-administered / 1 MCQ
Alaqeel A, et al.3 / 2014 / Saudi Arabia / NS / Assess the level of strokeawareness in the Saudi population / Based on survey of National Stroke Association and American Stroke Association, reviewed by 1 neurologist, and pilot testing / NS / / / / / / Interview / 9 T/F or OEQ
Bogoshi G, et al.4 / 2003 / South Africa / A honorary lecturer of the physiotherapy department / Assess and compare theknowledge of stroke risk factors among black patients diagnosed with hypertension, diabetes andstroke / NS / NS / / / Interview / 30 T/F or OEQ
BorhaniHaghighi A, et al.5 / 2010 / Iran / NS / Assess the baseline SK in an Iranian urban population / NS / Patients at neurology clinics / / / / / / / / Interview / 45 5-point Likert scale
Bray JE, et al.6 / 2013 / Australia / NS / Examine the Australian public’s awarenessof stroke warning signs among residents ≥ 40 years old / NS / NS / / / / / Interview / 6 MCQ or OEQ
Christian AH, et al.7 / 2007 / USA / NS / Track trendsin awareness, knowledge, and perceptions relatedto heart disease and stroke among women / NS / NS / / / / / Interview / 9 4-point Likert scale
DeSorbo AL, et al.8 / 2013 / USA / NS / Assess learning among children of fourth- tosixth-grade after a stroke health education program / NS / NS / / Self-administered / 5 T/F questions
Donkor, ES, et al.9 / 2014 / Ghana / NS / Evaluate stroke awareness in Accra (capitalcity of Ghana) among general public / Literature review and hospital presentationin different geographical settings, and pilot testing / NS / / / / / / / Self-administered / 10 T/F or MCQ
Evci ED, et al.10 / 2007 / Turkey / NS / Determine the levelof SK in people40 years old and registering at the health centers in a city of Turkey / Literature review and pilot testing / NS / / / / / Interview / 6 T/F, MCQ or OEQ
Fogle CC, et al.11 / 2010 / USA / NS / Assess thecommunity awareness of warning signs for stroke and the need to call 911among general public / Previously published questionnaires and pilot testing / NS / / / Interview / 5 OEQ
Hickey A, et al.12 / 2012 / Ireland / NS / Establish populationknowledge of risk factors and warning signs for stroke inadults in the Republic of Ireland / Previous surveys, revision, and pilot testing / NS / / / / / / / / Interview / 18 OEQ
Hickey A, et al.13 / 2009 / Ireland / NS / Examine knowledge of stroke warning signs andrisk factors among community-dwelling older adults / Previous US survey by American Stroke Association, National Stroke Associationand the National Institute of Neurological Disorders / Elderly / / / Interview / 2 MCQ
Hodgson C, et al.14 / 2007 / Canada / NS / Track knowledge of the warning signs of stroke among Ontarians aged ≥45 / From previously published questionnaires / NS / / / Interview / 12 MCQ or OEQ
Itzhaki M, et al.15 / 2014 / Israel / NS / Explore the knowledge,thoughts and perceptions of stroke among Arab Muslims inIsrael / Adaptedfrom previously published questionnaires / NS / / / / / Interview / 5 MCQ
Jurkowski JM, et al.16 / 2008 / USA / NS / Examine respondents’ intent to call 911 among adults ≥30 years old living in four upstate New York counties / From previously published questionnaires / NS / / Interview / 7 MCQ
Kalenderian E, et al.17 / 2009 / USA / NS / Assess the level of public awareness of CVDand stroke among African-American and Latino population / NS / NS / / / / Self-administered / 3 MCQ
Lowe DB, et al.18 / 2007 / UK / NS / Assess the SK among patients with acute stroke / Adaptedfrom a previously published questionnaires / Patients with acute stroke / / / / Self-administered / 8 T/F, OEQ or MCQ
Massengo SA, et al.19 / 2013 / France / 1 neurologist / Evaluate the level of knowledge about selected clinical aspects of TIA among general practitioners and emergency department physicians / Fromchart review, consensus meeting, cognitive testing, and field testing / Physicians’TIA knowledge / / / / / / Self-administered / 26 T/F, MCQ
Middleton S, et al.20 / 2015 / Australia / NS / Assess knowledge of physical symptoms as warning signsof stroke among patients with carotid endarterectomy / Adapted from previous surveys by National Health and Medical Research Council and National Stroke Foundation in Australia / NS / / / / / Interview / 14 T/F, MCQ
Milner A, et al.21 / 2008 / USA / NS / Examine riskfactor and warning signs of stroke among graduate students in rehabilitation training programs / Adapted from previous heart disease/stroke statistics / NS / / / / Self-administered / 3 MCQ
Miyamatsu N, et al.22 / 2013 / Japan / NS / Assess general SK, early symptoms and response for stroke among 40-74 years old community dwellers / NS / NS / / / / Self-administered / 4 T/F, MCQ
Mochari-Greenberger H, et al.23 / 2014 / USA / NS / Evaluate knowledge of stroke warning signs and call 911 among a nationallyrepresentative sample of women / NS / NS / / / Interview / 2 OEQ
Montaner J, et al.24 / 2001 / Spain / Neurologists / Determine the SK (terminology, signsand symptoms, risk factorsand attitude) amongusers of Primary Health Centers / From previously published questionnaires / NS / / / / / Interview / 29 T/F or OEQ
Mosley I, et al.25 / 2014 / Australia / NS / Assess the stroke symptom knowledge among persons who called the ambulance to transport the stroke/TIA patients to hospital / NS / NS / / / Interview / 2 OEQ
Neau JP, et al.26 / 2009 / France / NS / Assess general public’s knowledge of stroke risk factors and warningsigns / NS / NS / / / / / Interview / 4 OEQ
Nedeltchev K, et al.27 / 2007 / Switzerland / NS / Assess the information needs of the general public / NS / People with TIA / / / / / / Interview / 11 OEQ or MCQ
O'Callaghan G, et al.28 / 2012 / Ireland / NS / Assess the knowledge of stroke among community-dwelling people > 40years old in Irish / From previously published questionnaires and pilot testing / NS / / / / / / Interview / 5 OEQ
Pierce C, et al.29 / 2011 / USA / NS / Measure the knowledge of signs andsymptoms of stroke among the rural general public / Literature review / NS / / / / / Self-administered / 13 T/F or MCQ
Pontes-Neto OM, et al.30 / 2008 / Brazil / NS / Simulate theresponse of laypersons to a real scenario of acute stroke ina close relative / Referred to a community-oriented “Stroke Chain of Survival” developed by the American Stroke Association / NS / / / / / Interview / 6 OEQ
Pratt CA, et al.31 / 2003 / USA / NS / Asses stroke knowledge amongAfrican Americans ≥ 50 years old / Based on the responses from five focus groups / African American / / / / / / Interview / 15 OEQ
Rowe AK, et al.32 / 2001 / USA / NS / Assess Georgia adults’ knowledge of stroke warning signs, stroke riskfactors, and emergency responses / NS / NS / / / / / Interview / 26 T/F or OEQ
Sanders K, et al.33 / 2014 / USA / NS / Assess the comprehension andretention of stroke information among patients with acute ischemic stroke / NS / NS / / / / / Interview / 4 OEQ
Segura T, et al.34 / 2003 / Spain / A neurologyprofessor / Assess the general public’s awareness of stroke in Spain / Written by one of the authors / NS / / / / / Interview / 7 OEQ
Sloma A, et al.35 / 2010 / Sweden / NS / Assess the stroke/TIA patients’ knowledge about diseases and risk factors / Literature review and pilot testing / NS / / Self-administered / 17 MCQ
Smith J, et al.36 / 2004 / UK / NS / Assess stroke knowledge among patients with acute strokeand their carers / Expanded from previously published questionnaires / NS / / / / / / Self-administered / 13 T/F questions
Sundseth A, et al.37 / 2014 / Norway / NS / Explore the knowledge of stroke symptoms and risk factors in a Norwegian populationwith acute stroke / NS / NS / / / Interview / 2 OEQ
Tadros A, et al.38 / 2009 / USA / NS / Assess the general public’s knowledge of stroke / From a previously published questionnaires / NS / / / / Interview / 3 OEQ
Tedim Cruz V, et al.39 / 2012 / Portugal / NS / Assess acute stroke detectionand action amongstroke patients’ relatives and neighbors / NS / NS / / / / / Interview / 4 MCQ
Travis LH, et al.40 / 2003 / USA / NS / Determine the knowledge of strokesymptoms, risk factors, and treatment among patients attending outpatient services / NS / NS / / / / / / / Self-administered / 7 MCQ
Vibo R, et al.41 / 2013 / Estonia / NS / Assess the knowledge of stroke risk factors and symptoms among the Estonian population / NS / NS / / / / / / Self-administered / 22 T/F questions
Vukovic V, et al.42 / 2009 / Croatia / A neurologyprofessor / Assess theknowledge regarding stroke risk factors, symptoms and emergencyresponsesamong patients without stroke/TIA historyattending outpatient services / Written by one of the authors / NS / / / / / Self-administered / 4 MCQ
Wahab KW, et al.43 / 2008 / Nigeria / NS / Assess the knowledge of warning signs in patients with hypertension, diabetes mellitus or both / Literature review and pilot testing / NS / / / / Interview / 5 OEQ
Wall HK, et al.44 / 2008 / USA / NS / Assess the message retention of stroke signs and symptoms among patients withstroke / NS / NS / / / Self-administered / 5 MCQ
Williams O, et al.45 / 2012 / USA / NS / Assess parental recall of stroke information communicated by theirelementary school children / NS / NS / / / / / Interview / 14 T/F, MCQ or OEQ
Wong WP, et al.46 / 2013 / Singapore / Scholarsatthe Department of Physical Therapy / Assess the knowledge on stroke risk factors, warning signs and responsesamong Singaporean Chinese adults ≥ 40 years old / Adapted from a previously developed questionnaires / NS / / / / Interview / 3 OEQ
Yang J, et al.47 / 2014 / China / NS / Investigate the recognition of stroke warning signs and emergency responses among the general public / Literature review and pilot testing / NS / / / Interview / 8 T/F or MCQ
Yvonne Chan YF, et al.48 / 2010 / USA / NS / Assess the knowledge of stroke signs, symptoms, risk factors, behavior modification, and the urgency to seek medical attention among nonacute patientsor visitors in the emergency department / NS / African American / / / / / / / Self-administered / 13 MCQ
Zerwic J, et al.49 / 2007 / USA / NS / Investigate the beliefof stroke symptoms andcauses among patients with ischemic stroke / Literature review, based on the CommonSense Model of Illness, and reviewed by experts in information-processing theory / NS / / / / / Interview / 5 OEQ
† Tests were not named by developers in published articles.
* Abbreviations: Multiple-choice question(MCQ); Open-ended questions(OEQ);yes/no(T/F); Not stated (NS)
References lists of the 49 SK tests:
1.Adelman EE, Meurer WJ, Nance DK, et al. Stroke awareness among inpatient nursing staff at an academic medical center. Stroke. 2014;45(1):271-273.
2.Akiyama H, Hasegawa Y. Knowledge of transient ischemic attack among the Japanese. J Stroke Cerebrovasc Dis. 2013;22(4):457-464.
3.Alaqeel A, AlAmmari A, AlSyefi N, Al-Hussain F, Mohammad Y. Stroke awareness in the Saudi community living in Riyadh: prompt public health measures must be implemented. Journal of Stroke & Cerebrovascular Diseases. 2014;23(3):500-504.
4.Bogoshi G, Stewart A, Hale L, Fritz V. Knowledge of stroke risk factors amongst black diabetic, hypertensive and stroke patients. South African Journal of Physiotherapy. 2003;59(4):25-32.
5.Borhani Haghighi A, Karimi AA, Amiri A, Ghaffarpasand F. Knowledge and attitude towards stroke risk factors, warning symptoms and treatment in an Iranian population. Medical Principles & Practice. 2010;19(6):468-472.
6.Bray JE, Johnson R, Trobbiani K, et al. Australian public's awareness of stroke warning signs improves after national multimedia campaigns. Stroke. 2013;44(12):3540-3543.
7.Christian AH, Rosamond W, White AR, Mosca L. Nine-year trends and racial and ethnic disparities in women's awareness of heart disease and stroke: an American Heart Association national study. Journal of Women's Health. 2007;16(1):68-81.
8.DeSorbo AL, Noble JM, Shaffer M, Gerin W, Williams OA. The use of an audience response system in an elementary school-based health education program. Health Education & Behavior. 2013;40(5):531-535.
9.Donkor ES, Owolabi MO, Bampoh P, Aspelund T, Gudnason V. Community awareness of stroke in Accra, Ghana. BMC Public Health. 2014;14:196.
10.Evci ED, Memis S, Ergin F, Beser E. A population-based study on awareness of stroke in Turkey. European Journal of Neurology. 2007;14(5):517-522.
11.Fogle CC, Oser CS, McNamara MJ, Helgerson SD, Gohdes D, Harwell TS. Impact of media on community awareness of stroke warning signs: a comparison study. Journal of Stroke & Cerebrovascular Diseases. 2010;19(5):370-375.
12.Hickey A, Holly D, McGee H, Conroy R, Shelley E. Knowledge of stroke risk factors and warning signs in Ireland: development and application of the Stroke Awareness Questionnaire (SAQ). International Journal of Stroke. 2012;7(4):298-306.
13.Hickey A, O'Hanlon A, McGee H, et al. Stroke awareness in the general population: knowledge of stroke risk factors and warning signs in older adults. BMC Geriatrics. 2009;9:35.
14.Hodgson C, Lindsay P, Rubini F. Can mass media influence emergency department visits for stroke? Stroke. 2007;38(7):2115-2122.
15.Itzhaki M, Koton S. Knowledge, perceptions and thoughts of stroke among Arab-Muslim Israelis. European Journal of Cardiovascular Nursing. 2014;13(1):78-85.
16.Jurkowski JM, Maniccia DM, Dennison BA, Samuels SJ, Spicer DA. Awareness of necessity to call 9-1-1 for stroke symptoms, upstate New York. Preventing Chronic Disease. 2008;5(2):A41.
17.Kalenderian E, Pegus C, Francis C, et al. Cardiovascular Disease urban intervention: baseline activities and findings. Journal of Community Health. 2009;34(4):282-287.
18.Lowe DB, Sharma AK, Leathley MJ. The CareFile Project: a feasibility study to examine the effects of an individualised information booklet on patients after stroke. Age & Ageing. 2007;36(1):83-89.
19.Massengo SA, Cisse M, Guiziou C, Leray E, Rajabally YA, Edan G. Knowledge of TIA among general practitioners and emergency department physicians. A questionnaire survey in a French semi-rural area. Clinical Neurology & Neurosurgery. 2013;115(8):1457-1463.
20.Middleton S, Donnelly N, Harris J, Ward J. Nursing intervention after carotid endarterectomy: a randomized trial of Co-ordinated Care Post-Discharge (CCPD). Journal of Advanced Nursing. 2005;52(3):250-261.
21.Milner A, Lewis WJ, Ellis C. Knowledge of stroke risk factors and early warning signs of stroke among students enrolled in allied health programs: a pilot study. Journal of Allied Health. 2008;37(4):e296-315.
22.Miyamatsu N, Okamura T, Nakayama H, et al. Public awareness of early symptoms of stroke and information sources about stroke among the general Japanese population: the Acquisition of Stroke Knowledge Study. Cerebrovascular Diseases. 2013;35(3):241-249.
23.Mochari-Greenberger H, Towfighi A, Mosca L. National women's knowledge of stroke warning signs, overall and by race/ethnic group. Stroke. 2014;45(4):1180-1182.
24.Montaner J, Vidal C, Molina C, Alvarez-Sabin J. Selecting the target and the message for a stroke public education campaign: a local survey conducted by neurologists. European Journal of Epidemiology. 2001;17(6):581-586.
25.Mosley I, Nicol M, Donnan G, Thrift AG, Dewey HM. What is stroke symptom knowledge? International Journal of Stroke. 2014;9(1):48-52.
26.Neau JP, Ingrand P, Godeneche G. Awareness within the French population concerning stroke signs, symptoms, and risk factors. Clinical Neurology & Neurosurgery. 2009;111(8):659-664.
27.Nedeltchev K, Fischer U, Arnold M, Kappeler L, Mattle HP. Low awareness of transient ischemic attacks and risk factors of stroke in a Swiss urban community. Journal of Neurology. 2007;254(2):179-184.
28.O'Callaghan G, Murphy S, Loane D, Farrelly E, Horgan F. Stroke knowledge in an Irish semi-rural community-dwelling cohort and impact of a brief education session. Journal of Stroke & Cerebrovascular Diseases. 2012;21(8):629-635; quiz 636-628.
29.Pierce C, Fahs PS, Dura A, et al. Raising stroke awareness among rural dwellers with a Facts for Action to Stroke Treatment-based educational program. Applied Nursing Research. 2011;24(2):82-87.
30.Pontes-Neto OM, Silva GS, Feitosa MR, et al. Stroke awareness in Brazil: alarming results in a community-based study. Stroke. 2008;39(2):292-296.
31.Pratt CA, Ha L, Levine SR, Pratt CB. Stroke knowledge and barriers to stroke prevention among African Americans: implications for health communication. Journal of Health Communication. 2003;8(4):369-381.
32.Rowe AK, Frankel MR, Sanders KA. Stroke awareness among Georgia adults: epidemiology and considerations regarding measurement. Southern Medical Journal. 2001;94(6):613-618.
33.Sanders K, Schnepel L, Smotherman C, et al. Assessing the impact of health literacy on education retention of stroke patients. Preventing Chronic Disease. 2014;11:E55.
34.Segura T, Vega G, Lopez S, Rubio F, Castillo J. Public perception of stroke in Spain. Cerebrovascular Diseases. 2003;16(1):21-26.
35.Sloma A, Backlund LG, Strender LE, Skaner Y. Knowledge of stroke risk factors among primary care patients with previous stroke or TIA: a questionnaire study. BMC Family Practice. 2010;11:47.
36.Smith J, Forster A, Young J. A randomized trial to evaluate an education programme for patients and carers after stroke. Clinical Rehabilitation. 2004;18(7):726-736.
37.Sundseth A, Faiz KW, Ronning OM, Thommessen B. Factors related to knowledge of stroke symptoms and risk factors in a norwegian stroke population. Journal of Stroke & Cerebrovascular Diseases. 2014;23(7):1849-1855.
38.Tadros A, Crocco T, Davis SM, et al. Emergency medical services-based community stroke education: pilot results from a novel approach. Stroke. 2009;40(6):2134-2142.
39.Tedim Cruz V, Araujo I, Alves I, Magano A, Coutinho P. Freeze the stroke: public awareness program for immediate detection of first symptoms. Stroke. 2012;43(9):2510-2512.
40.Travis LH, Flemming KD, Brown RD, Jr., Meissner I, McClelland RL, Weigand SD. Awareness of stroke risk factors, symptoms, and treatment is poor in people at highest risk. Journal of Stroke & Cerebrovascular Diseases. 2003;12(5):221-227.
41.Vibo R, Korv L, Vali M, et al. Stroke awareness in two Estonian cities: better knowledge in subjects with advanced age and higher education. European Neurology. 2013;69(2):89-94.
42.Vukovic V, Mikula I, Kesic MJ, et al. Perception of stroke in Croatia--knowledge of stroke signs and risk factors amongst neurological outpatients. European Journal of Neurology. 2009;16(9):1060-1065.
43.Wahab KW, Okokhere PO, Ugheoke AJ, Oziegbe O, Asalu AF, Salami TA. Awareness of warning signs among suburban Nigerians at high risk for stroke is poor: a cross-sectional study. BMC Neurology. 2008;8:18.
44.Wall HK, Beagan BM, O'Neill J, Foell KM, Boddie-Willis CL. Addressing stroke signs and symptoms through public education: the Stroke Heroes Act FAST campaign. Preventing Chronic Disease. 2008;5(2):A49.
45.Williams O, DeSorbo A, Noble J, Gerin W. Child-Mediated Stroke Communication: findings from Hip Hop Stroke. Stroke. 2012;43(1):163-169.
46.Wong WP, Yeung M, Loh S, et al. Stroke-related knowledge, lifestyle behaviours and health beliefs in Singaporean Chinese: Implications for health education. Health Education Journal. 2013;72(4):386-397.
47.Yang J, Zheng M, Cheng S, et al. Knowledge of stroke symptoms and treatment among community residents in Western Urban China. Journal of Stroke & Cerebrovascular Diseases. 2014;23(5):1216-1224.
48.Yvonne Chan YF, Nagurka R, Richardson LD, Zaets SB, Brimacombe MB, Levine SR. Effectiveness of stroke education in the emergency department waiting room. Journal of Stroke & Cerebrovascular Diseases. 2010;19(3):209-215.
49.Zerwic J, Hwang SY, Tucco L. Interpretation of symptoms and delay in seeking treatment by patients who have had a stroke: exploratory study. Heart & Lung. 2007;36(1):25-34.
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