Stroke is a significant public health concern worldwide, representing a major cause of morbidity and mortality. It is a sudden and often debilitating event that can have long-lasting consequences on an individual's quality of life. In India, stroke is emerging as a leading cause of death and disability, with a growing burden on healthcare systems and resources. District Kangra, situated in the northern Indian state of Himachal Pradesh, is not immune to this alarming trend. Understanding the awareness and knowledge levels of the general public regarding the risk factors and prevention of stroke in this region is imperative to develop effective public health interventions [1-3].

Stroke is a medical condition that occurs when there is a disruption in blood supply to the brain, resulting in brain tissue damage. It can be broadly categorized into two types: ischemic stroke, caused by the blockage of blood vessels, and hemorrhagic stroke, caused by the rupture of blood vessels. While advancements in medical science have led to better stroke management and treatment options, prevention remains the most effective strategy in reducing the burden of stroke [4-6].

Public awareness and knowledge of stroke risk factors and preventive measures play a pivotal role in this prevention effort. Studies have shown that a lack of awareness and knowledge among the general public can result in delayed recognition of stroke symptoms, leading to delayed medical intervention, and subsequently,poorer outcomes. Furthermore, understanding the risk factors for stroke can empower individuals to make healthier lifestyle choices, reducing their overall risk [7-9].

To address this issue, this study aims to assess the awareness and knowledge levels regarding stroke risk factors and prevention among the general public in District Kangra. By identifying gaps in knowledge and misconceptions, we can tailor public health campaigns and educational programs to improve stroke awareness and prevention efforts in this region.

This study is timely and critical, given the increasing burden of stroke in India and the potential for early intervention and lifestyle modification to reduce stroke incidence. By shedding light on the awareness and knowledge gaps specific to District Kangra, we hope to contribute to the development of targeted and effective strategies for stroke prevention and management in this community.

Objectives of the Study

The primary objective of this study is to evaluate the awareness and knowledge regarding risk and preventive factors for stroke among the general public of District Kangra.

Study Design and Setting

This research employed a cross-sectional survey design to comprehensively assess the knowledge about Risk and Preventive factors for Stroke among the diverse general population of District Kangra. Known for its unique demographic composition and urban lifestyle, District Kangra provided an interesting backdrop for this study. Data collection and analysis were conducted over a meticulously planned three-month period, spanning from May 2023 to July 2023.

Study Population and Sample Size

The study's target population encompassed all adults aged 18 and above who had been residents of District Kangra for a minimum of 12 months. A robust sample size of 400 adults was determined using a 95% confidence level, an estimated knowledge level of 50% regarding Stroke risk and preventive factors, a precise 5% absolute error margin, and a conservative 5% non-response rate. This scientifically rigorous approach not only ensured statistical significance but also allowed for the generalizability of the findings to the larger population of District Kangra.

Data Collection Tool

A meticulously crafted and rigorously validated Google Form questionnaire served as the primary instrument for data collection. This questionnaire comprised two sections, each serving a specific purpose. The first section diligently gathered essential socio-demographic information, including age, gender, marital status, religion, employment, and education, to provide a comprehensive profile of the study participants. The second section contained 20 carefully designed questions aimed at assessing participants' knowledge of Stroke risk and preventive factors.

Scoring System for Knowledge Assessment

A structured scoring system was employed for evaluating participants' knowledge levels regarding Stroke risk and preventive factors. For each correct response, participants were awarded one mark, while incorrect answers received zero marks. This scoring system enabled the categorization of participants' knowledge into four distinct groups: "very good" (>80%), "good" (60-79%), "fair" (41-59%), and "poor" (<40%). Such granularity in knowledge assessment facilitated a nuanced understanding of overall awareness levels among the respondents.

Data Collection

Data collection procedures were meticulously conducted under the vigilant supervision of experienced researchers to ensure the highest levels of accuracy and reliability. The Google Form questionnaire was strategically disseminated through a variety of online platforms, including email, WhatsApp groups, Facebook, Instagram, and LinkedIn. This comprehensive approach aimed to reach both rural and urban areas within District Kangra, capturing a diverse cross-section of the population.

Ethical Considerations

Ethical considerations were of paramount importance throughout the study to safeguard the rights and well-being of the participants. Informed consent, a fundamental ethical prerequisite, was diligently obtained from all participants before their inclusion in the study. Their voluntary involvement and privacy were prioritized at all stages. To guarantee the utmost confidentiality, personal information was anonymized and securely stored. The study adhered to stringent ethical guidelines governing research involving human participants, fostering an environment of trust and respect between the researchers and the study population.

Data Analysis

The collected data underwent rigorous scrutiny to ensure its accuracy and completeness upon entry into a Microsoft Excel spreadsheet. For data analysis, the sophisticated Epi Info V7 software was employed. Utilizing appropriate statistical tests, including frequencies and percentages, the findings were presented in a clear and concise manner. The data analysis aimed not only to ascertain the level of knowledge concerning Stroke risk and preventive factors among the general public of District Kangra but also to pinpoint specific knowledge gaps requiring targeted attention.

This study aimed to provide valuable insights into the understanding of Stroke risk and prevention among the residents of District Kangra, with the collected data offering a comprehensive overview of the current knowledge landscape on this critical health concern. A total of 400 respondents actively participated in this study, representing a diverse cross-section of the population. Among these respondents, 242 individuals (60.5%) hailed from urban areas within District Kangra, while the remaining 158 individuals (39.5%) were from rural areas.

In the present study 30% (120) participants had very good knowledge (16-20 marks) towards Risk and Preventive factors for Stroke, 38.25% (153) had good knowledge (12-15 marks), 19.5% (78) had fair knowledge (8-11 marks) and 12.25% (49) having poor knowledge (<8 marks).

Table 1: Knowledge Regarding Risk and Preventive Factors for Stroke among Study Participants

Table 2: Knowledge Scores Towards Risk and Preventive Factors for Stroke among Study Participants

The findings of this study shed light on the levels of awareness and knowledge regarding stroke risk factors and prevention among the general public of District Kangra, India. Stroke is a significant health concern in India, and understanding the knowledge gaps and awareness levels in specific regions like District Kangra is essential for designing effective public health interventions.

In this study, we observed that a substantial proportion of the respondents had a good understanding of key aspects related to stroke risk factors and prevention. Notably, the majority of participants correctly identified common risk factors associated with stroke, such as high blood pressure, smoking, physical inactivity, and diabetes. Additionally, a significant percentage of respondents recognized the importance of lifestyle factors, such as a balanced diet, regular exercise, and stress management, in reducing stroke risk. These findings are consistent with previous studies conducted in different regions of India, which have also highlighted the importance of these risk factors in stroke prevention [7-10].

However, there were also notable knowledge gaps identified in this study. For instance, a considerable number of respondents were unaware of the specific age groups more vulnerable to stroke, the role of family history in determining stroke risk, and the warning signs or symptoms of a stroke. These gaps in knowledge are critical as they can impact the timely recognition of stroke symptoms and the importance of seeking immediate medical attention, which is crucial for optimal stroke management [9-12].

The study's findings also revealed that a significant proportion of respondents had limited knowledge about community resources or programs providing information about stroke prevention. This highlights the need for increased awareness about available resources and support systems within the community to promote stroke prevention and management.

To bridge these knowledge gaps, targeted public health campaigns and educational initiatives should be developed and implemented in District Kangra. These programs should focus on raising awareness about stroke risk factors, recognizing stroke symptoms, and promoting preventive measures. Community-based interventions, involving healthcare professionals, local leaders, and educational institutions, can play a crucial role in disseminating accurate information and dispelling misconceptions.

Limitations

Limitations of this study include the use of a self-reported questionnaire, which may be subject to recall bias and social desirability bias. Additionally, the study's sample size, while scientifically determined, may not represent the entire population of District Kangra. Future research could explore the impact of interventions aimed at improving stroke awareness and knowledge in this region.

In conclusion, this study provides valuable insights into the awareness and knowledge levels of stroke risk factors and prevention among the general public in District Kangra, India. While there is room for improvement, the findings suggest that a substantial proportion of respondents have a good understanding of key aspects related to stroke prevention. Targeted interventions and awareness campaigns can help address knowledge gaps and contribute to better stroke management and prevention in this community.

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