Hip Hop to Stroke Awareness

What do hip hop and beauty salons have in common?

Both offer captive audiences for teaching children the signs and symptoms of a stroke, researchers report.

In a study of about 400 kids who hip-hopped to stroke awareness, the proportion that could recognize two or more warning signs jumped from 28% to about 60%.

In separate research, beauticians increased their clients' recognition of stroke symptoms by teaching them about the disease while they had their hair styled.

Both programs, presented here at the American Stroke Association's International Stroke Conference 2007, targeted African-Americans, who are twice as likely to have a first stroke as whites.

Programs Create Stroke Heroes

In at least two cases, fast action by 10-year-old kids who had completed the rap program may have been lifesaving: Both called 9-1-1 after recognizing that an adult was experiencing symptoms of a stroke, says Olajide Williams, MD, a neurologist at Harlem Hospital Center who led the program.

"Some call them stroke heroes. I call them the first knights of the hip hop program," he tells WebMD.

Williams says the hip hop project was aimed at "tough kids in tough schools" -- fourth- and six-graders, ages 9 to 11, in Harlem.

Interactive Rap Video Central to Program

Central to the three-day program: a live hip hop video performed by legendary rapper Doug E. Fresh.

"Fresh wrote an interactive stroke rap called 'Brain Attack'," Williams says. "After he shouted a line, the kids would scream it back."

The tune incorporated the FAST acronym -- face, arm, speech, time -- for teaching stroke warning signs and a plan of action.

Weakness or numbness on one side of the face or in one arm, and slurred speech, are warning signs of a stroke. Time refers to need to call 9-1-1 immediately.

A stroke occurs when blood flow to an area of the brain is compromised -- such as with a blood clot or bleeding in the brain. This leads to the death of brain cells and brain damage.

Stroke is the leading cause of adult disability in America and third leading cause of death.

Other components of the rap program for children included simplified brain maps to teach the function of the brain; a virtual reality video showing how a stroke occurs; and an animated video showing people in the throes of a stroke.

The youngsters also performed an interactive skit in which each was assigned to personify a stroke symptom, such as "Mr. Blindness" or "Mr. Garbled Speech," William says. "We had a lot of fun."
Hip Hop Reaches Parents of Tomorrow

Even more important, the program worked.

Before the study, only 32% of the children knew that a stroke occurs in the brain; when tested three months later, 84% did.

And while only 37% of the kids knew two or more ways to prevent a stroke beforehand, 76% did afterwards.

The program has already been replicated in schools in seven other cities and Williams is looking to expand it even further.

Donna Ferriero, MD, chief of child neurology at the University of California, San Francisco, says she thinks the program is "outstanding."

"They are reaching young people, who are the young parents of tomorrow. If we can get the signs of symptoms of stroke embedded at an early age, we can make a difference," she tells WebMD.

Salons Offer Supportive Environment

Like the youngsters, the beauticians -- who themselves were taught the warning signs of a stroke, turned out to be stroke heroes -- says Dawn Kleindorfer, MD, a stroke neurologist and associate professor at the University of Cincinnati.

This study involved 30 beauticians from two different urban areas in the U.S.

"One hairdresser noticed that a woman's speech was slurred, and called for help. Another beautician recognized a client's symptoms as signs of a stroke and called 9-1-1," she says.

Kleindorfer says her team chose to use th beauty salons to spread the word about stroke because "African-American women generally have regular appointments with women they know and trust. It's a friendly, social, and supportive environment."

The researchers invited the beauticians to a training luncheon, during which they were treated to a power-point orientation about stroke warning signs and talks by stroke survivors between courses.

Again, the "FAST" acronym was stressed.

Then, armed with education materials, they were asked to talk to their clients about stroke while styling women's hair.

Afterwards, the beauticians gave their clients a packet, including cookbooks and wallet cards with warning signs, to take home, Kleindorfer says.

At the start of the program, only 41% of the 300 women studied could name three warning signs of a stroke. Afterwards, 51% could.

The percentage of women who recognized the need to call 911 immediately also jumped, from 85% to 93%.

But knowledge of stroke risk factors -- hypertension, diabetes, smoking, high cholesterol, heart disease, increasing age, African-American race, and male gender -- did not.

"One reason may be because risk factors are a more abstract concept; we didn't have a mnemonic like FAST we could use to help them remember," Kleindorfer tells WebMD.

SOURCES: International Stroke Conference, Feb. 7-9, 2007, San Francisco. Olajide Williams, MD, department of neurology, Harlem Hospital Center. Dawn Kleindorfer, MD, associate professor of neurology, University of Cincinnati. Donna Ferriero, MD, chief of child neurology, University of California, San Francisco. American Heart Association: "Heart Disease and Stroke Statistics -- 2007 Update.