Stroke, a cerebrovascular event characterized by the sudden disruption of blood flow to the brain, represents a significant global health challenge. It is a leading cause of disability and mortality worldwide, posing substantial economic and healthcare burdens. While strokes can have devastating consequences, many are preventable through risk factor management and public awareness [1-3].

Stroke occurs when there is a disruption of blood flow to the brain, leading to the death of brain cells due to oxygen deprivation. There are two main types of strokes: ischemic stroke, caused by the blockage of a blood vessel in the brain, and haemorrhagic stroke, resulting from the rupture of a blood vessel. Both types can have severe consequences, including paralysis, speech difficulties, and cognitive impairments [4-6].

Numerous risk factors contribute to the development of strokes, which can be broadly categorized into modifiable and non-modifiable factors. Non-modifiable factors include age, gender, and family history of stroke. Modifiable risk factors encompass lifestyle choices such as smoking, unhealthy diet, physical inactivity, hypertension, diabetes, obesity, and high cholesterol. Raising awareness about these risk factors and advocating for healthier lifestyles are fundamental aspects of stroke prevention [7-10].

Preventive strategies for strokes include adopting a heart-healthy diet, engaging in regular physical activity, managing blood pressure and cholesterol levels, quitting smoking, controlling diabetes, and maintaining a healthy weight. Additionally, early recognition of stroke symptoms and seeking immediate medical attention is crucial to minimize brain damage and improve outcomes [9-11].

Public awareness campaigns play a vital role in reducing stroke-related morbidity and mortality by promoting early recognition of stroke symptoms and encouraging risk factor management [11,12]. Understanding the current levels of awareness and knowledge among the general public in Himachal Pradesh is essential for designing effective awareness programs and interventions.

This study employs a systematic approach to assess public awareness and knowledge regarding stroke risk factors and preventive strategies in Himachal Pradesh. By identifying gaps in awareness and knowledge, this research aims to inform targeted health promotion strategies that can enhance stroke prevention, recognition, and timely intervention. Ultimately, improving public awareness in Himachal Pradesh can contribute to the reduction of stroke-related disability and mortality in this scenic state.

Objectives of the Study

To evaluate the awareness and knowledge regarding Risk and Preventive factors for Stroke among general public of  Himachal Pradesh.

Study Design and Setting

This research employed a cross-sectional survey design to evaluate the knowledge about Risk and Preventive factors for Stroke among the general population of Himachal Pradesh, known for its diverse population and urban lifestyle. Data collection and analysis took place over a duration of three months, from April 2023 to July 2023.

Study Population and Sample Size

The study's target population consisted of all adults above 18 years of age who had been residing in Himachal Pradesh for at least 12 months. A sample size of 400 adults was determined using a confidence level of 95%, an estimated knowledge level of 50% about Stroke risk and preventive factors, a 5% absolute error, and a 5% non-response rate. This sample size ensured that the findings could be generalized to the larger population and provided sufficient representation.

Data Collection Tool

A well-structured and validated Google Form questionnaire was developed to collect data on the knowledge of Stroke risk and preventive factors. The questionnaire comprised two sections: the first section gathered socio-demographic data, including age, gender, marital status, religion, employment, and education. The second section included 20 carefully crafted questions to assess participants' knowledge about Stroke risk and preventive factors. Each correct response was given one mark, while incorrect answers received zero marks. Participants' knowledge levels were categorized into four groups based on their scores: very good (>80%), good (60-79%), fair (41-59%), and poor (<40%).

Data Collection

Data collection was supervised by experienced personnel to ensure accuracy and reliability. The Google Form questionnaire was distributed through various online platforms, including email, WhatsApp groups, Facebook, Instagram, and LinkedIn, to reach both rural and urban areas of Himachal Pradesh. Participants were provided with informed consent before their inclusion in the study, and their personal information was treated confidentially. Ethical guidelines were strictly adhered to throughout the study, ensuring the privacy and anonymity of all respondents.

Data Analysis

Collected data was meticulously entered into a Microsoft Excel spreadsheet, where it was thoroughly checked for accuracy and completeness. Epi Info V7 software was utilized for data analysis. Descriptive statistics, such as frequencies and percentages, were employed to present the findings in a clear and concise manner. The data analysis aimed to identify the level of knowledge about Stroke risk and preventive factors among the general public of Himachal Pradesh and highlight any knowledge gaps that required attention.

The goal of the current study was to assess the knowledge regarding Risk and Preventive factors for Stroke among general public of Himachal Pradesh.

A total of 400 respondents took part in the study, with 278 (69.5%) coming from urban areas and 122 (30.5%) from rural areas. 

In the present study 24.25% (97) participants had very good knowledge (16-20 marks) towards Risk and Preventive factors for Stroke, 36.5% (146) had good knowledge (12-15 marks), 21.25% (85) had fair knowledge (8-11 marks) and 18% (72) having poor knowledge (<8 marks).

Table 1: Knowledge regarding Risk and Preventive factors for Stroke among study participants

Figure 1: Knowledge scores towards Risk and Preventive factors for Stroke among study participants

Stroke represents a significant global health challenge, and understanding the awareness and knowledge of stroke risk factors and preventive strategies among the general public is crucial for designing effective interventions. This discussion analyses the findings of the study, highlighting areas of strength and identifying knowledge gaps. Additionally, it compares these findings with previous research to provide a comprehensive perspective on stroke awareness in Himachal Pradesh.

The study revealed varying levels of awareness and knowledge regarding stroke risk factors among the participants. While 72.5% of respondents could provide a basic definition of stroke, indicating a reasonable understanding of the condition, some participants struggled to define it. This suggests a need for educational efforts to improve the general public's ability to recognize and describe strokes accurately.

A significant proportion (63.5%) of respondents correctly identified common risk factors associated with stroke, including hypertension, smoking, physical inactivity, and diabetes. These findings indicate that the general public in Himachal Pradesh has a fair understanding of some stroke risk factors. However, there is room for improvement, particularly in recognizing the role of family history, age, obesity, and excessive alcohol consumption in stroke risk.

Participants demonstrated relatively good awareness of preventive measures for stroke. A notable 65.25% correctly named preventive measures, indicating a positive understanding of actions that can reduce stroke risk. This includes maintaining a balanced diet, regular exercise, managing cholesterol levels, and reducing stress and anxiety. These findings suggest that public health initiatives focusing on stroke prevention have had some success in Himachal Pradesh.

Knowledge regarding stroke symptoms and the importance of immediate action is crucial for reducing stroke-related morbidity and mortality. In this study, 66.75% participants recognized the significance of seeking immediate medical attention during a suspected stroke, highlighting an understanding of the time-sensitive nature of stroke management. However, there is room for improvement in identifying specific stroke symptoms, as only 42.25% of respondents could do so.

The findings of this study align with previous research conducted in various regions [10-14]. Similar studies have shown that while there is a reasonable level of awareness regarding stroke risk factors and preventive measures, there are notable gaps in knowledge, particularly concerning specific risk factors like family history and age.

The study's results have several implications for public health initiatives in Himachal Pradesh. Firstly, efforts should focus on enhancing public awareness about the accurate definition of stroke, specific risk factors, and the recognition of stroke symptoms. Tailored educational programs can bridge these knowledge gaps and empower individuals to take preventive actions and seek immediate medical attention when necessary. Secondly, initiatives promoting healthier lifestyles, such as maintaining a balanced diet, engaging in regular physical activity, and reducing stress, should be continued and expanded. These lifestyle modifications can significantly contribute to stroke prevention. Thirdly, campaigns should target specific risk factors that participants had difficulty recognizing, such as family history, age, obesity, and excessive alcohol consumption. Raising awareness about these factors is essential for comprehensive stroke prevention. Lastly, community resources and programs that provide information about stroke prevention should be better advertised and made accessible to the general public. This can further enhance awareness and knowledge in the population.

The study provides valuable insights into the level of awareness and knowledge among the general public in Himachal Pradesh regarding stroke risk factors and preventive strategies. While there is a fair understanding of some aspects, there are notable gaps in knowledge that require targeted interventions. Public health initiatives should aim to improve awareness of specific risk factors, recognition of stroke symptoms, and the importance of immediate action. These efforts have the potential to reduce stroke-related disability and mortality in the region.

Ethical Approval

Ethical considerations were of utmost importance throughout the study. Informed consent was obtained from all participants before their participation, ensuring their voluntary involvement in the research. To protect the privacy and confidentiality of respondents, all data was anonymized and kept secure. Ethical guidelines for research involving human participants were strictly adhered to, fostering trust and respect between the researchers and the study population.

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