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