Appendix 2. Characteristics of the 49 SK tests used in only 1 published study

Authors† Year Country DevelopersPurpose of the test

Methods of development

Tailored to target population

SK concepts

Administration method

No. of items

Definition

Epidemiology

Risk factors

Warning signs

Emergency

response

Symptom

s

Treatment/

rehabilitation

Adelman EE, et al.1 2014 USA NS Evaluate SK among inpatient and emergency department nursing staff

NS NS Interview 1 OEQ

Akiyama, H, et al.2 2013 Japan NS Assess SK and TIA in general public

NS NS Self-administered

1 MCQ

1

Alaqeel A, et al.3 2014 Saudi Arabia

NS Assess the level of stroke awareness in the Saudi population

Based on survey of National Stroke Association and American Stroke Association, reviewed by 1 neurologist, and pilot testing

NS Interview 9 T/F or OEQ

2

Bogoshi G, et al.4 2003 South Africa

A honorary lecturer of the physiotherapy department

Assess and compare the knowledge of stroke risk factors among black patients diagnosed with hypertension, diabetes and stroke

NS NS Interview 30 T/F or OEQ

Borhani Haghighi A, et al.5

2010 Iran NS Assess the baseline SK in an Iranian urban population

NS Patients at neurology clinics

Interview 45 5-point Likert scale

Bray JE, et al.6 2013 Australia NS Examine the Australian public’s awareness of stroke warning signs among residents ≥ 40 years old

NS NS Interview 6 MCQ or OEQ

3

Christian AH, et al.7 2007 USA NS Track trends in awareness, knowledge, and perceptions related to heart disease and stroke among women

NS NS Interview 9 4-point Likert scale

DeSorbo AL, et al.8 2013 USA NS Assess learning among children of fourth- to sixth-grade after a stroke health education program

NS NS Self-administered

5 T/F questions

Donkor, ES, et al.9 2014 Ghana NS Evaluate stroke awareness in Accra (capital city of Ghana) among general public

Literature review and hospital presentation in different geographical settings, and pilot testing

NS Self-administered

10 T/F or MCQ

4

Evci ED, et al.10 2007 Turkey NS Determine the level of SK in people > 40 years old and registering at the health centers in a city of Turkey

Literature review and pilot testing

NS Interview 6 T/F, MCQ or OEQ

Fogle CC, et al.11 2010 USA NS Assess the community awareness of warning signs for stroke and the need to call 911 among general public

Previously published questionnaires and pilot testing

NS Interview 5 OEQ

Hickey A, et al.12 2012 Ireland NS Establish population knowledge of risk factors and warning signs for stroke in adults in the Republic of Ireland

Previous surveys, revision, and pilot testing

NS Interview 18 OEQ

5

Hickey A, et al.13 2009 Ireland NS Examine knowledge of stroke warning signs and risk factors among community-dwelling older adults

Previous US survey by American Stroke Association, National Stroke Association and the National Institute of Neurological Disorders

Elderly Interview 2 MCQ

Hodgson C, et al.14 2007 Canada NS Track knowledge of the warning signs of stroke among Ontarians aged ≥ 45

From previously published questionnaires

NS Interview 12 MCQ or OEQ

6

Itzhaki M, et al.15 2014 Israel NS Explore the knowledge, thoughts and perceptions of stroke among Arab Muslims in Israel

Adapted from previously published questionnaires

NS Interview 5 MCQ

Jurkowski JM, et al.16

2008 USA NS Examine respondents’ intent to call 911 among adults ≥ 30 years old living in four upstate New York counties

From previously published questionnaires

NS Interview 7 MCQ

Kalenderian E, et al.17

2009 USA NS Assess the level of public awareness of CVD and stroke among African-American and Latino population

NS NS Self-administered

3 MCQ

7

Lowe DB, et al.18 2007 UK NS Assess the SK among patients with acute stroke

Adapted from a previously published questionnaires

Patients with acute stroke

Self-administered

8 T/F, OEQ or MCQ

Massengo SA, et al.19

2013 France 1 neurologist

Evaluate the level of knowledge about selected clinical aspects of TIA among general practitioners and emergency department physicians

From chart review, consensus meeting, cognitive testing, and field testing

Physicians’ TIA knowledge

Self-administered

26 T/F, MCQ

8

Middleton S, et al.20 2015 Australia NS Assess knowledge of physical symptoms as warning signs of stroke among patients with carotid endarterectomy

Adapted from previous surveys by National Health and Medical Research Council and National Stroke Foundation in Australia

NS Interview 14 T/F, MCQ

Milner A, et al.21 2008 USA NS Examine risk factor and warning signs of stroke among graduate students in rehabilitation training programs

Adapted from previous heart disease/stroke statistics

NS Self-administered

3 MCQ

9

Miyamatsu N, et al.22

2013 Japan NS Assess general SK, early symptoms and response for stroke among 40-74 years old community dwellers

NS NS Self-administered

4 T/F, MCQ

Mochari-Greenberger H, et al.23

2014 USA NS Evaluate knowledge of stroke warning signs and call 911 among a nationally representative sample of women

NS NS Interview 2 OEQ

10

Montaner J, et al.24 2001 Spain Neurologists

Determine the SK (terminology, signs and symptoms, risk factors and attitude) among users of Primary Health Centers

From previously published questionnaires

NS Interview 29 T/F or OEQ

Mosley I, et al.25 2014 Australia NS Assess the stroke symptom knowledge among persons who called the ambulance to transport the stroke/TIA patients to hospital

NS NS Interview 2 OEQ

Neau JP, et al.26 2009 France NS Assess general public’s knowledge of stroke risk factors and warning signs

NS NS Interview 4 OEQ

11

Nedeltchev K, et al.27

2007 Switzerland

NS Assess the information needs of the general public

NS People with TIA

Interview 11 OEQ or MCQ

O'Callaghan G, et al.28

2012 Ireland NS Assess the knowledge of stroke among community-dwelling people > 40 years old in Irish

From previously published questionnaires and pilot testing

NS Interview 5 OEQ

Pierce C, et al.29 2011 USA NS Measure the knowledge of signs and symptoms of stroke among the rural general public

Literature review

NS Self-administered

13 T/F or MCQ

12

Pontes-Neto OM, et al.30

2008 Brazil NS Simulate the response of laypersons to a real scenario of acute stroke in a close relative

Referred to a community-oriented “Stroke Chain of Survival” developed by the American Stroke Association

NS Interview 6 OEQ

Pratt CA, et al.31 2003 USA NS Asses stroke knowledge among African Americans ≥ 50 years old

Based on the responses from five focus groups

African American

Interview 15 OEQ

Rowe AK, et al.32 2001 USA NS Assess Georgia adults’ knowledge of stroke warning signs, stroke risk factors, and emergency responses

NS NS Interview 26 T/F or OEQ

13

Sanders K, et al.33 2014 USA NS Assess the comprehension and retention of stroke information among patients with acute ischemic stroke

NS NS Interview 4 OEQ

Segura T, et al.34 2003 Spain A neurology professor

Assess the general public’s awareness of stroke in Spain

Written by one of the authors

NS Interview 7 OEQ

Sloma A, et al.35 2010 Sweden NS Assess the stroke/TIA patients’ knowledge about diseases and risk factors

Literature review and pilot testing

NS Self-administered

17 MCQ

14

Smith J, et al.36 2004 UK NS Assess stroke knowledge among patients with acute stroke and their carers

Expanded from previously published questionnaires

NS Self-administered

13 T/F questions

Sundseth A, et al.37 2014 Norway NS Explore the knowledge of stroke symptoms and risk factors in a Norwegian population with acute stroke

NS NS Interview 2 OEQ

Tadros A, et al.38 2009 USA NS Assess the general public’s knowledge of stroke

From a previously published questionnaires

NS Interview 3 OEQ

15

Tedim Cruz V, et al.39

2012 Portugal NS Assess acute stroke detection and action among stroke patients’ relatives and neighbors

NS NS Interview 4 MCQ

Travis LH, et al.40 2003 USA NS Determine the knowledge of stroke symptoms, risk factors, and treatment among patients attending outpatient services

NS NS Self-administered

7 MCQ

Vibo R, et al.41 2013 Estonia NS Assess the knowledge of stroke risk factors and symptoms among the Estonian population

NS NS Self-administered

22 T/F questions

16

Vukovic V, et al.42 2009 Croatia A neurology professor

Assess the knowledge regarding stroke risk factors, symptoms and emergency responses among patients without stroke/TIA history attending outpatient services

Written by one of the authors

NS Self-administered

4 MCQ

Wahab KW, et al.43 2008 Nigeria NS Assess the knowledge of warning signs in patients with hypertension, diabetes mellitus or both

Literature review and pilot testing

NS Interview 5 OEQ

17

Wall HK, et al.44 2008 USA NS Assess the message retention of stroke signs and symptoms among patients with stroke

NS NS Self-administered

5 MCQ

Williams O, et al.45 2012 USA NS Assess parental recall of stroke information communicated by their elementary school children

NS NS Interview 14 T/F, MCQ or OEQ

Wong WP, et al.46 2013 Singapore

Scholars at the Department of Physical Therapy

Assess the knowledge on stroke risk factors, warning signs and responses among Singaporean Chinese adults ≥ 40 years old

Adapted from a previously developed questionnaires

NS Interview 3 OEQ

18

Yang J, et al.47 2014 China NS Investigate the recognition of stroke warning signs and emergency responses among the general public

Literature review and pilot testing

NS Interview 8 T/F or MCQ

Yvonne Chan YF, et al.48

2010 USA NS Assess the knowledge of stroke signs, symptoms, risk factors, behavior modification, and the urgency to seek medical attention among nonacute patients or visitors in the emergency department

NS African American

Self-administered

13 MCQ

19

Zerwic J, et al.49 2007 USA NS Investigate the belief of stroke symptoms and causes among patients with ischemic stroke

Literature review, based on the Common Sense Model of Illness, and reviewed by experts in information-processing theory

NS Interview 5 OEQ

† Tests were not named by developers in published articles.

* Abbreviations: Multiple-choice question (MCQ); Open-ended questions (OEQ); yes/no (T/F); Not stated (NS)

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References lists of the 49 SK tests:

1. Adelman EE, Meurer WJ, Nance DK, et al. Stroke awareness among inpatient nursing staff at an academic medical center. Stroke. 2014;45(1):271-273.2. Akiyama H, Hasegawa Y. Knowledge of transient ischemic attack among the Japanese. J Stroke Cerebrovasc Dis. 2013;22(4):457-464.3. Alaqeel A, AlAmmari A, AlSyefi N, Al-Hussain F, Mohammad Y. Stroke awareness in the Saudi community living in Riyadh: prompt public health measures must be implemented. Journal of Stroke & Cerebrovascular Diseases. 2014;23(3):500-504.4. Bogoshi G, Stewart A, Hale L, Fritz V. Knowledge of stroke risk factors amongst black diabetic, hypertensive and stroke patients. South African Journal of Physiotherapy. 2003;59(4):25-32.5. Borhani Haghighi A, Karimi AA, Amiri A, Ghaffarpasand F. Knowledge and attitude towards stroke risk factors, warning symptoms and treatment in an Iranian population. Medical Principles & Practice. 2010;19(6):468-472.6. Bray JE, Johnson R, Trobbiani K, et al. Australian public's awareness of stroke warning signs improves after national multimedia campaigns. Stroke. 2013;44(12):3540-3543.7. Christian AH, Rosamond W, White AR, Mosca L. Nine-year trends and racial and ethnic disparities in women's awareness of heart disease and stroke: an American Heart Association national study. Journal of Women's Health. 2007;16(1):68-81.8. DeSorbo AL, Noble JM, Shaffer M, Gerin W, Williams OA. The use of an audience response system in an elementary school-based health education program. Health Education & Behavior. 2013;40(5):531-535.9. Donkor ES, Owolabi MO, Bampoh P, Aspelund T, Gudnason V. Community awareness of stroke in Accra, Ghana. BMC Public Health. 2014;14:196.10. Evci ED, Memis S, Ergin F, Beser E. A population-based study on awareness of stroke in Turkey. European Journal of Neurology. 2007;14(5):517-522.11. Fogle CC, Oser CS, McNamara MJ, Helgerson SD, Gohdes D, Harwell TS. Impact of media on community awareness of stroke warning signs: a comparison study. Journal of Stroke & Cerebrovascular Diseases. 2010;19(5):370-375.

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12. Hickey A, Holly D, McGee H, Conroy R, Shelley E. Knowledge of stroke risk factors and warning signs in Ireland: development and application of the Stroke Awareness Questionnaire (SAQ). International Journal of Stroke. 2012;7(4):298-306.13. Hickey A, O'Hanlon A, McGee H, et al. Stroke awareness in the general population: knowledge of stroke risk factors and warning signs in older adults. BMC Geriatrics. 2009;9:35.14. Hodgson C, Lindsay P, Rubini F. Can mass media influence emergency department visits for stroke? Stroke. 2007;38(7):2115-2122.15. Itzhaki M, Koton S. Knowledge, perceptions and thoughts of stroke among Arab-Muslim Israelis. European Journal of Cardiovascular Nursing. 2014;13(1):78-85.16. Jurkowski JM, Maniccia DM, Dennison BA, Samuels SJ, Spicer DA. Awareness of necessity to call 9-1-1 for stroke symptoms, upstate New York. Preventing Chronic Disease. 2008;5(2):A41.17. Kalenderian E, Pegus C, Francis C, et al. Cardiovascular Disease urban intervention: baseline activities and findings. Journal of Community Health. 2009;34(4):282-287.18. Lowe DB, Sharma AK, Leathley MJ. The CareFile Project: a feasibility study to examine the effects of an individualised information booklet on patients after stroke. Age & Ageing. 2007;36(1):83-89.19. Massengo SA, Cisse M, Guiziou C, Leray E, Rajabally YA, Edan G. Knowledge of TIA among general practitioners and emergency department physicians. A questionnaire survey in a French semi-rural area. Clinical Neurology & Neurosurgery. 2013;115(8):1457-1463.20. Middleton S, Donnelly N, Harris J, Ward J. Nursing intervention after carotid endarterectomy: a randomized trial of Co-ordinated Care Post-Discharge (CCPD). Journal of Advanced Nursing. 2005;52(3):250-261.21. Milner A, Lewis WJ, Ellis C. Knowledge of stroke risk factors and early warning signs of stroke among students enrolled in allied health programs: a pilot study. Journal of Allied Health. 2008;37(4):e296-315.22. Miyamatsu N, Okamura T, Nakayama H, et al. Public awareness of early symptoms of stroke and information sources about stroke among the general Japanese population: the Acquisition of Stroke Knowledge Study. Cerebrovascular Diseases. 2013;35(3):241-249.23. Mochari-Greenberger H, Towfighi A, Mosca L. National women's knowledge of stroke warning signs, overall and by race/ethnic group. Stroke. 2014;45(4):1180-1182.

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24. Montaner J, Vidal C, Molina C, Alvarez-Sabin J. Selecting the target and the message for a stroke public education campaign: a local survey conducted by neurologists. European Journal of Epidemiology. 2001;17(6):581-586.25. Mosley I, Nicol M, Donnan G, Thrift AG, Dewey HM. What is stroke symptom knowledge? International Journal of Stroke. 2014;9(1):48-52.26. Neau JP, Ingrand P, Godeneche G. Awareness within the French population concerning stroke signs, symptoms, and risk factors. Clinical Neurology & Neurosurgery. 2009;111(8):659-664.27. Nedeltchev K, Fischer U, Arnold M, Kappeler L, Mattle HP. Low awareness of transient ischemic attacks and risk factors of stroke in a Swiss urban community. Journal of Neurology. 2007;254(2):179-184.28. O'Callaghan G, Murphy S, Loane D, Farrelly E, Horgan F. Stroke knowledge in an Irish semi-rural community-dwelling cohort and impact of a brief education session. Journal of Stroke & Cerebrovascular Diseases. 2012;21(8):629-635; quiz 636-628.29. Pierce C, Fahs PS, Dura A, et al. Raising stroke awareness among rural dwellers with a Facts for Action to Stroke Treatment-based educational program. Applied Nursing Research. 2011;24(2):82-87.30. Pontes-Neto OM, Silva GS, Feitosa MR, et al. Stroke awareness in Brazil: alarming results in a community-based study. Stroke. 2008;39(2):292-296.31. Pratt CA, Ha L, Levine SR, Pratt CB. Stroke knowledge and barriers to stroke prevention among African Americans: implications for health communication. Journal of Health Communication. 2003;8(4):369-381.32. Rowe AK, Frankel MR, Sanders KA. Stroke awareness among Georgia adults: epidemiology and considerations regarding measurement. Southern Medical Journal. 2001;94(6):613-618.33. Sanders K, Schnepel L, Smotherman C, et al. Assessing the impact of health literacy on education retention of stroke patients. Preventing Chronic Disease. 2014;11:E55.34. Segura T, Vega G, Lopez S, Rubio F, Castillo J. Public perception of stroke in Spain. Cerebrovascular Diseases. 2003;16(1):21-26.35. Sloma A, Backlund LG, Strender LE, Skaner Y. Knowledge of stroke risk factors among primary care patients with previous stroke or TIA: a questionnaire study. BMC Family Practice. 2010;11:47.

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36. Smith J, Forster A, Young J. A randomized trial to evaluate an education programme for patients and carers after stroke. Clinical Rehabilitation. 2004;18(7):726-736.37. Sundseth A, Faiz KW, Ronning OM, Thommessen B. Factors related to knowledge of stroke symptoms and risk factors in a norwegian stroke population. Journal of Stroke & Cerebrovascular Diseases. 2014;23(7):1849-1855.38. Tadros A, Crocco T, Davis SM, et al. Emergency medical services-based community stroke education: pilot results from a novel approach. Stroke. 2009;40(6):2134-2142.39. Tedim Cruz V, Araujo I, Alves I, Magano A, Coutinho P. Freeze the stroke: public awareness program for immediate detection of first symptoms. Stroke. 2012;43(9):2510-2512.40. Travis LH, Flemming KD, Brown RD, Jr., Meissner I, McClelland RL, Weigand SD. Awareness of stroke risk factors, symptoms, and treatment is poor in people at highest risk. Journal of Stroke & Cerebrovascular Diseases. 2003;12(5):221-227.41. Vibo R, Korv L, Vali M, et al. Stroke awareness in two Estonian cities: better knowledge in subjects with advanced age and higher education. European Neurology. 2013;69(2):89-94.42. Vukovic V, Mikula I, Kesic MJ, et al. Perception of stroke in Croatia--knowledge of stroke signs and risk factors amongst neurological outpatients. European Journal of Neurology. 2009;16(9):1060-1065.43. Wahab KW, Okokhere PO, Ugheoke AJ, Oziegbe O, Asalu AF, Salami TA. Awareness of warning signs among suburban Nigerians at high risk for stroke is poor: a cross-sectional study. BMC Neurology. 2008;8:18.44. Wall HK, Beagan BM, O'Neill J, Foell KM, Boddie-Willis CL. Addressing stroke signs and symptoms through public education: the Stroke Heroes Act FAST campaign. Preventing Chronic Disease. 2008;5(2):A49.45. Williams O, DeSorbo A, Noble J, Gerin W. Child-Mediated Stroke Communication: findings from Hip Hop Stroke. Stroke. 2012;43(1):163-169.46. Wong WP, Yeung M, Loh S, et al. Stroke-related knowledge, lifestyle behaviours and health beliefs in Singaporean Chinese: Implications for health education. Health Education Journal. 2013;72(4):386-397.47. Yang J, Zheng M, Cheng S, et al. Knowledge of stroke symptoms and treatment among community residents in Western Urban China.

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Journal of Stroke & Cerebrovascular Diseases. 2014;23(5):1216-1224.48. Yvonne Chan YF, Nagurka R, Richardson LD, Zaets SB, Brimacombe MB, Levine SR. Effectiveness of stroke education in the emergency department waiting room. Journal of Stroke & Cerebrovascular Diseases. 2010;19(3):209-215.49. Zerwic J, Hwang SY, Tucco L. Interpretation of symptoms and delay in seeking treatment by patients who have had a stroke: exploratory study. Heart & Lung. 2007;36(1):25-34.

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