Educating the next generation about stroke

By Darla Brown

A sudden weakness and numbness envelopes half of your face. Your right arm and leg go limp. You are unable to speak and feel like you will faint.

You know that you need help and should call 911 to report these classic stroke symptoms, but you can’t. Will someone near you – a family member, a co-worker, a stranger – make that call? And fast?

Time is the enemy for a stroke victim – delay in calling emergency medical services is the most important factor limiting acute stroke therapy. The powerful clot dissolving drug t-PA (tissue plasminogen activator), for instance, can be used most effectively within the first three hours of the onset of ischemic stroke symptoms.

And while you may know when to call 911 to report a stroke emergency – if you were the victim, would you be able to?

“Research we at the UT Houston Stroke Program did in Lufkin, Texas, shows that only 4.5 percent of the time the patient calls 911 themselves. Instead, they rely upon those around them – most of the time family members,” says Lewis B. Morgenstern, M.D., director of the Stroke Program at the University of Michigan Medical School and adjunct clinical associate professor of neurology at UT.


Creating a stroke education program that involves both children and their parents was the idea behind a proposal to the National Institutes of Health that Dr. Morgenstern wrote while an associate professor of neurology during his eight years at the UT Medical School. The original idea was conceived by James Grotta, M.D., professor and director of the UT Stroke Program, for the purpose of training a new generation about stroke.

Aimed at educating middle school students and their families about stroke and when to call 911, Kids Defeating Stroke (KIDS) is now in its second year in Corpus Christi, Texas. For one week each year, three middle school classes across this coastal city have one hour of stroke education a day, which is followed by homework assignments.

“We have aimed this intervention at children not only to make note of the fact that they can make that call to 911 themselves, but for the children also to take the message home to their parents and grandparents,” Dr. Morgenstern says.

UT stroke fellow Nicole Gonzales, M.D., was a lecturer in one of the classes last fall.

“We have a lot of interaction with the students in our presentation and try to stay away from lecturing,” she says. “It’s a tough group to capture.”

Unlike most homework assignments – KIDS tasks require the involvement of parents or guardians.

“The first assignment is a pre-test so we can have a baseline on what the kids and their families know about stroke. Then we follow up with some educational assignments and will conclude with a post-test to measure our results,” Dr. Morgenstern explains.

The post-test will be conducted at the end of the three-year program when the students are in the 8th grade.

Stroke afflicts more than 700,000 U.S. residents each year and is the third leading cause of death. Corpus Christi’s demographics – more than half of the residents are Hispanic – elevates the city’s stroke susceptibility.

“The rate of stroke in Mexican-Americans is 12 to 100 percent higher depending on age compared to non-Hispanics,” Dr. Morgenstern says.

Since Dr. Morgenstern’s move to Michigan in 2002, KIDS has become a joint project between the two medical schools, with several staff members from UT and Michigan participating in the project.

Dr. Morgenstern administrates the program off site through phone calls and e-mails and makes a visit once a month. “It’s not that big of a change – just an hour and a half longer plane ride from Detroit than it was from Houston. I’m still a Texan at heart,” he says.

The KIDS project works in tandem with, and grew out of, a more comprehensive 10-year, NIH-funded program, BASIC (Brain Attack Surveillance In Corpus Christi), which started in 1999, tracking all strokes in the area to determine differences among ethnicities regarding access to care and stroke knowledge. This project is also a collaboration between UT and the University of Michigan.

“The purpose of BASIC is to compare stroke in non-Hispanics to Hispanics, looking at the incidence rates of both populations and why differences – social and biological – occur,” Dr. Morgenstern explains.

Dr. Morgenstern says he is hopeful that this stoke education will be part of the schools’ permanent curriculum, affecting long-term change regarding how Corpus Christi residents respond to stroke symptoms. “Corpus is our pilot city. Ultimately, we would like to see this stroke curriculum in schools across the country, if it proves effective,” he says.