Quality of Life Research

, Volume 26, Issue 8, pp 2153–2160 | Cite as

Effect of a comprehensive health education program on pre-hospital delay intentions in high-risk stroke population and caregivers

  • Li Yang
  • Qiuli ZhaoEmail author
  • Xuemei Zhu
  • Xiaoying Shen
  • Yulan Zhu
  • Liu Yang
  • Wei Gao
  • Minghui Li



Many factors influence pre-hospital delays in the event of stroke. This study aimed to develop and evaluate a comprehensive educational program for decreasing pre-hospital delays in high-risk stroke population.


We enrolled 220 high-risk stroke population and caregivers from six urban communities in Harbin from May 2013 to May 2015, and randomly divided them into intervention and control groups. We implemented a comprehensive educational program (intervention group), comprising public lectures, instructional brochures, case videos, simulations, and role-playing from May 2013 to May 2015. We delivered conventional oral education in the control group. We compared stroke pre-hospital delay behavioral intention (SPDBI), pre-hospital stroke symptom coping test (PSSCT), and stroke pre-symptoms alert test (SPSAT) results between the groups before and 6, 12, and 18 months after health intervention.


There were significant differences between before and after intervention (P < 0.01). SPDBI, PSSCT, and SPSAT scores were significantly different between the groups (P < 0.01). The interaction between time and intervention method was significant (P < 0.01). According to multivariate repeated measures analysis of variance, SPDBI, PSSCT, and SPSAT scores were significantly different at each time after intervention (P < 0.05).


The comprehensive educational program was significantly effective in decreasing SPDBI, improving knowledge, enhancing stroke pre-symptoms alert, and reducing the possibility of pre-hospital delays.


Stroke High-risk stroke population Pre-hospital delay Health education 



The co-authors would like to thank all community service personnel who helped with the study, and the participants of the study. We also thank Jiangping Ma who give us lots of help in revising the article about statistical analysis. Moreover, the National Natural Science Foundation of China (No. 81273194) funded this project.


This project was supported by the National Natural Science Foundation of China (No. 81273194).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Li Yang
    • 1
  • Qiuli Zhao
    • 1
    Email author
  • Xuemei Zhu
    • 1
  • Xiaoying Shen
    • 1
  • Yulan Zhu
    • 2
  • Liu Yang
    • 1
  • Wei Gao
    • 1
  • Minghui Li
    • 1
  1. 1.School of NursingHarbin Medical UniversityHarbinPeople’s Republic of China
  2. 2.Department of NeurologyThe 2nd Affiliated Hospital of Harbin Medical UniversityHarbinPeople’s Republic of China

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