Open Access Highly Accessed Research article

Systematic review of mass media interventions designed to improve public recognition of stroke symptoms, emergency response and early treatment

Jan Lecouturier1, Helen Rodgers2, Madeleine J Murtagh3, Martin White1, Gary A Ford2 and Richard G Thomson1*

Author Affiliations

1 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK

2 Institute for Ageing and Health (Stroke Research Group), Newcastle University, Newcastle upon Tyne, UK

3 Medical and Social Care Education, Leicester University, Leicester, UK

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BMC Public Health 2010, 10:784  doi:10.1186/1471-2458-10-784

Published: 23 December 2010



Mass media interventions have been implemented to improve emergency response to stroke given the emergence of effective acute treatments, but their impact is unclear.


Systematic review of mass media interventions aimed at improving emergency response to stroke, with narrative synthesis and review of intervention development.


Ten studies were included (six targeted the public, four both public and professionals) published between 1992 and 2010. Only three were controlled before and after studies, and only one had reported how the intervention was developed. Campaigns aimed only at the public reported significant increase in awareness of symptoms/signs, but little impact on awareness of need for emergency response. Of the two controlled before and after studies, one reported no impact on those over 65 years, the age group at increased risk of stroke and most likely to witness a stroke, and the other found a significant increase in awareness of two or more warning signs of stroke in the same group post-intervention. One campaign targeted at public and professionals did not reduce time to presentation at hospital to within two hours, but increased and sustained thrombolysis rates. This suggests the campaign had a primary impact on professionals and improved the way that services for stroke were organised.


Campaigns aimed at the public may raise awareness of symptoms/signs of stroke, but have limited impact on behaviour. Campaigns aimed at both public and professionals may have more impact on professionals than the public. New campaigns should follow the principles of good design and be robustly evaluated.