Evidence map›Paper›PMID 40884082›Full record

Trial reportInternational journal of stroke : official journal of the International Stroke Society2026

Efficacy of five strategies to improve stroke action awareness in Spanish-speaking adults: A randomized comparison.

Juan Manuel Marquez-Romero, Karen Itzel Sánchez-Ramírez, Carlos David Pérez-Malagón, Jannett Padilla-López, Gary A Ford, Jing Zhao, Renyu Liu

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in International journal of stroke : official journal of the International Stroke Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Juan Manuel Marquez-RomeroDepartamento de Neurología. Hospital General de Zona #2, Instituto Mexicano del Seguro Social. OOAD Aguascalientes, Aguascalientes, México.ORCID 0000-0002-5059-1174
Karen Itzel Sánchez-RamírezFacultad de Medicina, Universidad Autónoma de Sinaloa, Culiacan, México.
Carlos David Pérez-MalagónDepartamento de Neurología. Hospital General de Zona #2, Instituto Mexicano del Seguro Social. OOAD Aguascalientes, Aguascalientes, México.
Jannett Padilla-LópezUnidad de Medicina Familiar #1, Instituto Mexicano del Seguro Social. OOAD Aguascalientes, Aguascalientes, México.
Gary A FordRadcliffe Department of Medicine, Division of Medical Sciences, Oxford University, Oxford, UK.
Jing ZhaoDepartment of Neurology, Minhang Hospital, Fudan University, Shanghai, China.ORCID 0000-0001-5197-9181
Renyu LiuDepartments of Anesthesiology and Critical Care, and Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsImproving stroke action awareness is challenging in non-English-speaking populations. In this study, we evaluated the effectiveness of five Spanish-language educational tools in improving recognition and making an emergency response to stroke symptoms among Spanish-speaking adults in Mexico.

methodsSpanish-speaking participants were recruited from public spaces. Individuals with a history of stroke were excluded. Participants were randomly assigned to receive an educational session tailored to one of five stroke awareness tools (RAPIDO, DALE, CAMALEON, CORRE, and ICTUS 911). Stroke knowledge was assessed using the Stroke Awareness Questionnaire before the educational intervention and after 6-9 days of follow-up. The primary outcome was the change in the proportions of correctly identified stroke symptoms. Secondary outcomes included changes in participants' achievement of adequate stroke knowledge in individual FAST domains and their understanding of the appropriate actions to take after identifying stroke symptoms.

resultsIn data from 435 participants, all strategies improved stroke symptom recognition and risk factor awareness, although no statistically significant differences were observed in the primary outcomes. Changes ranged from 0.35 (DALE) to 0.49 (CAMALEON) for Facial Weakness, the symptom with the largest improvement, and from 0.00 (CAMALEON, CORRE, RAPIDO) to 0.15 (DALE) for Problems with Vision, the symptom with the smallest improvement. For the secondary outcomes, increases in adequate stroke knowledge ranged from 0.18 (CORRE, DALE) to 0.31 (ICTUS 911); between-group comparisons were statistically significant (p = 0.027). Improvements in appropriate action after symptom recognition ranged from 0.09 (RAPIDO) to 0.29 (ICTUS 911), with significant differences across groups (p = 0.034).

conclusionsThis study shows that brief educational interventions can improve stroke symptom recognition and intended response in Spanish-speaking adults. Among five strategies, ICTUS 911 yielded the largest short-term gains, supporting its potential utility. Further research is needed to assess long-term effectiveness and broader applicability.

Indexed as

AwarenessHealth EducationHealth Knowledge, Attitudes, PracticeStrokeAdultAgedFemaleHumansLanguageMaleMexicoMiddle AgedSurveys and Questionnairesemergency responseprehospital delayspublic health educationSpanish-speaking populationsStroke awareness

Identifiers

PMID40884082
PMCPMC12932688

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.