IEFInternational Education Forum3083-49022981-8605Bio-Byword Scientific Publishing Pty. Ltd.10.26689/IEF.v4i8.15530ArticleEffects of a Child-Mediated Family-Based Stroke Education Intervention on Public First Aid Knowledge and Attitudeshttps://artdesignp.com/journal/IEF/4/8/10.26689/IEF.v4i8.15530WangJie,SaiJinping,RaoZhenzhen,ZhaoDongmei,TaoYanli,YangHaoying,PengJianying2026482026-08-31Objective: To investigate the current status of public knowledge and attitudes toward stroke first aid, and to explore the intervention effects of a child-mediated family health education model on stroke prevention. Methods: In March 2023, this study enrolled 264 fourth-grade students and their parents from two districts in Xiangyang City. A one-month child-mediated health education intervention was conducted, covering stroke risk factors, warning recognition, and emergency management. Professionally developed training videos were distributed digitally to schools and incorporated into weekly health education sessions (20-minute theoretical instruction + 20-minute practical training), followed by outcome evaluation. Results: Students’ knowledge scores significantly improved from 29.55±17.80 to 92.48±5.49 (P<0.001). Among parents, post-intervention knowledge and attitude scores were from 43.49±9.92 to 80.27±14.03 and from 60.04±14.26 to 85.98±13.23(P<0.001), respectively. Among parents, post-intervention knowledge was affected by age, education level, occupation, chronic diseases, and child-mediated education participation (P<0.05), while attitudes were associated with education level, occupation, chronic diseases, and child-mediated education participation (P<0.05). Conclusion: Public knowledge of stroke first aid requires urgent improvement, with multiple influencing factors identified. The child-mediated family health education model significantly enhances residents’ stroke health literacy.Stroke, Public, First-aid knowledge, Children, Family health education

[1] Fan J, Li X, Yu X, et al., 2023, Global Burden, Risk Factor Analysis, and Prediction Study of Ischemic Stroke, 1990-2030. Neurology, 101(2): e137–150. [2] Steinmetz JD, Seeher KM, Schiess N, et al., 2024, Global, Regional, and National Burden of Disorders Affecting the Nervous System, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021. The Lancet Neurology, 23(4): 344–381. [3] Feigin VL, Abdollahi A, Abreu LG, et al., 2024, Global, Regional, and National Burden of Stroke and its Risk Factors, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021. Lancet Neurology, 23(10): 973–1003. [4] Jiang Y, Xiong Y, Chi Y, et al., 2024, Healthcare-Seeking Delays in Acute Ischemic Stroke Patients: The Influence of Gender, Immigrant Status, and Educational Background. Risk Management and Healthcare Policy, 2024(17): 191–204. [5] Luan S, Yang Y, Huang Y, et al., 2021, Public Knowledge of Stroke and Heart Attack Symptoms in China: A Cross-Sectional Survey. BMJ Open, 11(1): e43220. [6] Yan LL, Gong E, Gu W, et al., 2021, Effectiveness of a Primary Care-based Integrated Mobile Health Intervention for Stroke Management in Rural China (SINEMA): A Cluster-randomized Controlled Trial. PLoS Med, 18(4): e1003582. [7] Holder C, Krishnamurthi R, Theadom A, 2023, Exploring Facilitators and Barriers to Long‐term Behavior Change Following Health–wellness Coaching for Stroke Prevention: A Qualitative Study Conducted in Auckland, New Zealand. Brain and Behavior, 13(1): e2671. [8] Finch E, Coleman A, Cameron A, et al., 2024, Utilising Interactive Technology for Stroke Patient Education: A Systematic Review. Disability and Rehabilitation: Assistive Technology, 19(4): 1236–1248. [9] Lwin MO, Malik S, Chua TSJ, et al., 2016, Intergenerational Transfer of Blood Pressure Knowledge and Screening: A School-based Hypertension Awareness Program in Singapore. Global Health Promotion, 23(1): 27–36. [10] Kageyama M, Matsushita A, Kobayashi A, et al., 2023, Video-based E-learning program for Schoolteachers to Support Children of Parents with Mental Illness: A Cluster Randomized Trial. BMC Public Health, 23(1): 523. [11] Vaidyanathan R, 2019, Immunization Coverage among under-five Children Living Along a School Student through Child-to-child and Child-to-parent Information, Education and Communication Strategy. Indian Journal of Public Health, 63(4): 334–340. [12] Ning M, Zheng HH, Jiang DH, et al., 2021, Influencing Factors of First-aid Knowledge and Training Effect among Elderly Residents in Haikou. Chinese Journal of Gerontology, 41(13): 2845–2849. [13] Feigin VL, Owolabi MO, 2023, Pragmatic Solutions to Reduce the Global Burden of Stroke: A World Stroke Organization-Lancet Neurology Commission. Lancet Neurology, 22(12): 1160–1206. [14] Zhao Y, Hua X, Ren X, et al., 2023, Increasing Burden of Stroke in China: A Systematic Review and Meta-analysis of Prevalence, Incidence, Mortality, and Case Fatality. International Journal of Stroke, 18(3): 259–267. [15] Ellepola S, Nadeesha N, Jayawickrama I, et al., 2022, Quality of Life and Physical Activities of Daily Living among Stroke Survivors; Cross-Sectional Study. Nursing Open, 9(3): 1635–1642. [16] Chowdhury SZ, Baskar PS, Bhaskar S, 2021, Effect of Prehospital Workflow Optimization on Treatment Delays and Clinical Outcomes in Acute Ischemic Stroke: A Systematic Review and Meta-analysis. Academic Emergency Medicine, 28(7): 781–801. [17] Bjorck A, Materne M, Arvidsson Lindvall M, et al., 2024, Investigating Cognitive Impairment, Biopsychosocial Barriers, and Predictors of Return to Daily Life among Older Stroke Survivors. Frontiers in Neurology, 2024(15): 1403567. [18] Huang H, Zhang L, Dong W, et al., 2024, Stigma and Loneliness among Young and Middle-aged Stroke Survivors: A Moderated Mediation Model of Interpersonal Sensitivity and Resilience. Journal of Psychiatric and Mental Health Nursing, 31(4): 596–606. [19] Rajan SS, Decker-Palmer M, Wise J, et al., 2021, Beneficial Effects of the 30-minute Door-To-needle Time Standard for Alteplase Administration. Annals of Clinical and Translational Neurology, 8(8): 1592–1600. [20] Londhe SR, Gg SK, Keshava SN, et al., 2021, Indian College of Radiology and Imaging (ICRI) Consensus Guidelines for the Early Management of Patients with Acute Ischemic Stroke: Imaging and Intervention. Indian Journal of Radiology and Imaging, 31(2): 400–408. [21] Al-Obaidi H, Khidhair Z, Jirjees F, et al., 2023, Factors Associated with Knowledge and Awareness of Stroke in the Iraqi Population: A Cross-Sectional Study. Frontiers in Neurology, 2023(14): 1144481. [22] Chen J, Zhu Q, Yu L, et al., 2022, Stroke Risk Factors of Stroke Patients in China: A Nationwide Community-Based Cross-Sectional Study. International Journal of Environmental Research and Public Health, 19(8): 4807. [23] Sese LVC, Guillermo MCL, 2023, Strengthening Stroke Prevention and Awareness in the Philippines: a conceptual framework. Frontiers in Neurology, 2023(14): 1258821. [24] Zhong X, Wang J, He L, et al., 2020, Recognition of Stroke-related Knowledge among Community Residents and the Improvement after Intensive Health Education: A Cross-sectional Study. BMC Neurology, 20(1): 373. [25] Liang J, Luo C, Ke S, et al., 2023, Stroke Related Knowledge, Prevention Practices and Associated Factors among Stroke Patients in Taizhou, China. Preventive Medicine Reports, 2023(35): 102340. [26] Abbasian M, Rashidi Birgani H, Khabiri R, et al., 2024, Exploring Education Interventions for Stroke Prevention Among Adults and Older Individuals: A Scoping Review. Health Science Reports, 7(11): e70167. [27] Saidu A, Lee K, Ismail I, et al., 2023, Effectiveness of Video Self-instruction Training on Cardiopulmonary Resuscitation Retention of Knowledge and Skills among Nurses in North-western Nigeria. Frontiers in Public Health, 2023(11): 1124270. [28] Dharmakulaseelan L, Ceci Galanos L, Guerrero R, et al., 2025, Knowledge Acquisition and Audience Retention in Stroke Education: Results from a Global Study by the World Stroke Organization. Stroke, 56(2): 521–526. [29] Xu JF, Jin PY, 2020, Investigation on Early Recognition and First-aid Knowledge among Family Members of Patients with Acute Myocardial Infarction. Chinese Journal of Preventive Medicine, 21(1): 103–106. [30] Zhang ML, Tang HM, Chen LB, et al., 2023, Exploration of a Full-life-cycle health Management Model with Family-community-hospital Linkage Based on Family Units. Chinese Journal of Health Management, 17(5): 392–394.