INTRODUCTION:

Stroke ranks as one of the leading non-communicable diseases globally, significantly contributing to long-term disability and mortality^12-13,17. As per the World Health Organization¹, one in four people aged over 25 will have a stroke at some point in their lives². Quick recognition of symptoms and understanding modifiable risk factors are essential for timely identification and effective treatment. Nevertheless, awareness levels are often inadequate, particularly among adults in marginalized community settings³.

Educational outreach regarding warning signs and modifiable risk factors for stroke is acknowledged as a cost-effective strategy for diminishing the overall consequences of stroke⁴. Utilizing multimedia teaching methods provides an engaging and scalable way to address literacy disparities and improve understanding among groups with limited educational experience^12,19,20.

A stroke occurs due to a sudden disruption in blood flow to the brain, either from an arterial blockage or rupture, resulting in the death of brain cells due to a lack of oxygen. It is also a significant cause of dementia and depression⁶. Low- and middle-income countries account for around 70% of all strokes, 87% of stroke-related fatalities, and 87% of disability-adjusted life years⁷.

To mitigate the overall impact of stroke, it is vital to raise public awareness and encourage prompt health-seeking behaviors. Treatments like thrombolysis are highly time-sensitive and are effective only within a limited timeframe, necessitating quick recognition of symptoms². Delays in getting to the hospital, insufficient knowledge of symptoms, and hesitance to seek medical help all significantly affect negative outcomes. Additionally, a lack of understanding regarding the management of conditions such as hypertension and the importance of healthy living further elevates the risk and severity of stroke⁸.

NEED FOR THE STUDY:

In India, the rate of stroke is increasing, presenting a concerning trend among younger adults⁶. Although prevalence differs by region, it tends to be higher in urban areas. Men are more often affected than women, yet the risk is rising for both sexes. A disturbing trend is the increasing incidence of stroke in younger demographics, highlighting the critical need for focused prevention and educational initiatives.^11,12,15,17

Stroke is the second largest cause of death globally and a significant contributor to disability^2,7. Ischemic stroke is the most common kind, and incidence are highest in developing nations⁶. Progress in understanding the pathophysiology of stroke has informed therapeutic approaches, which primarily aim to restore cerebral blood flow and mitigate neurological damage.

The World Stroke Organization promotes the theme Every Minute Counts for World Stroke Day, observed annually on October 29th, to emphasize the urgent importance of timely recognition of stroke symptoms¹.

In India, lifestyle changes linked to urbanization have increased the prevalence of hypertension, diabetes, and obesity—all critical changeable risk contributors for stroke^4,10,14,16. Although medical care has advanced, insufficient public awareness about risk contributors, warning signs, and prompt treatment continues to delay care and worsen outcomes^15,17,19. Promoting preventive practices through culturally tailored educational interventions is essential. The strategic teaching approach, especially through multimedia-based methods, offers an engaging, inclusive, and accessible way to raise knowledge and positively influence attitudes toward stroke prevention and management⁵^,¹¹^,¹²^,¹⁵^,¹⁷.

The purpose of this study was to assess how well an organized educational strategy can improve an adult's knowledge and attitudes regarding stroke risk factors and warning indicators.

OBJECTIVES:

The study was conducted with the following aims:

1. To assess pre- and post-intervention knowledge and attitudes regarding the risk factors, prevention, and management of stroke among adults.

2. To evaluate the effectiveness of video-assisted teaching in enhancing knowledge and attitudes regarding stroke risk factors, prevention, and management.

3. To explore the correlation between post-intervention knowledge and attitudes toward stroke prevention and management.

4. To identify association between post-intervention knowledge and attitude scores and the demographic characteristics of the participants.

MATERIALS AND METHODS:

Research Design and Setting:

The research utilized a quantitative, pre-experimental design employing a Pre-test–post-test approach for a single group. It was conducted in Chennai's Taramani neighborhood.

Sample and Sampling Technique A total of 100 adults, comprising both males and females, were selected through a non-probability convenience sampling technique.

The inclusion criteria were:

· Age 18 years and older

· Willingness to participate

· Ability to comprehend and communicate in Tamil

Exclusion criteria encompassed individuals with cognitive impairments or those who had previously undergone formal education regarding stroke.

Data Collection Tools:

1. Demographic Proforma: A total of ten semi-structured questions were employed to gather data regarding age, gender, education, income, dietary practices, and health background

2. Knowledge Questionnaire: A structured questionnaire with 20 multiple-choice items assessed knowledge about stroke risk factors, prevention, and management. Each item had one correct answer and three distractors.

· 75%: Sufficient knowledge

· 50–75%: Moderately sufficient knowledge

· <50%: Insufficient knowledge

3. The attitude Scale:

A Likert scale comprising 15 statements (both affirmative and negative) evaluated the participants’ attitudes towards stroke prevention and management. The response options included Strongly Agree, Agree, Uncertain, Disagree, and Strongly Disagree.

Procedure:

The institutional ethics committee gave its approval for ethical considerations. Documented consent Permission was obtained from every participant. On the first day, a preliminary test was given to evaluate initial understanding and perspective. Every interview took about 20 minutes.

Following the pre-test, participants attended a structured video-assisted teaching session covering stroke risk factors, preventive measures, and management strategies. The content was culturally adapted, presented in Tamil, and delivered to groups of 10–15 people. Each session lasted about 25–30 minutes.

A post-test using the same tools was conducted on Day 8 to measure changes in knowledge and attitude.

Analyzing Data:

Inferential statistics and descriptive statistics (frequency, percentage, mean, and standard deviation) were used to examine the data:

Pre-post comparisons are analyzed using the paired t-test; post-intervention knowledge and attitude are examined using Pearson's correlation coefficient; and post-test scores and demographic characteristics are compared using the chi-square test.

Outcome:

Participants' Demographic Profile:

Table 1 shows the distribution of adult demographic variables by frequency and percentage. (N = 100)

Population Variable	Category	(f)	(%)
Age of the demographic (in years)	< 30	14	14.0
	30–40	23	23.0
	41–50	36	36.0
	Above 50	27	27.0
Sex	Male	15	15.0
	Female	85	85.0
Religious beliefs	Hindu	84	84.0
	Christian	12	12.0
	Muslim	3	3.0
	Others	1	1.0
Education	No formal education	79	79.0
	Primary education	21	21.0
Monthly Income	< 5,000	7	7.0
	5,001–10,000	86	86.0
	10,001–15,000	7	7.0
Nutritional Habits	Vegetarian	12	12.0
	Non-vegetarian	88	88.0
Type of Family	Nuclear family	53	53.0
	Joint family	36	36.0
	Extended family	11	11.0
History of Stroke	Yes	15	15.0
	No	85	85.0
History of Chronic Illness	Yes	51	51.0
	No	49	49.0
Type of Medication	Anti-diabetic	53	53.0
	Anti-hypertensive	35	35.0
	Both	12	12.0

The demographic details of the 100 persons who took part in the study are shown in Table 1.

· Age: Most participants (36%) were between 41–50 years, followed by 27% aged above 50 years.

· Gender: Females constituted the majority (85%), with males accounting for 15%.

· Religion: Hinduism was the predominant religion (84%), followed by Christianity (12%), Islam (3%), and others (1%).

· Education: A significant proportion (79%) had no formal education, while 21% had completed primary education.

· Monthly Income: The majority (86%) reported earnings between ₹5,001–₹10,000.

· Dietary Pattern: Most (88%) were non-vegetarians.

· Family Type: Over half (53%) belonged to nuclear families, 36% to joint families, and 11% to extended families.

· History of Stroke: Only 15% had a prior history of stroke.

· Chronic Illness: Slightly more than half (51%) reported chronic illnesses.

· Medication: Anti-diabetic drugs were used by 53%, anti-hypertensive drugs by 35%, and both by 12%.

Knowledge Assessment:

Before the intervention, 86% of participants demonstrated insufficient knowledge, 12% had moderately sufficient knowledge, and only 2% had sufficient knowledge.

Knowledge and Attitude Correlation:

Table 2c: Relation between Attitude and Post-Test Knowledge

Variables	Karl pearson’s correlation	P-value
Knowledge	R= - 0.0994	0.324
Attitude	R= - 0.0994	0.324

Table 2c indicates that post - test knowledge and attitude ratings had a weak negative connection (r = -0.0994) that was not statistically significant (p = 0.324).

Association with Demographic Variables:

Post-test knowledge or attitude scores did not significantly correlate with demographic factors such age, gender, religion, education, income, eating habits, or family type, according to chi-square analysis. This suggests that the instructional intervention was equally successful in various subgroups.

DISCUSSION:

This research aimed to evaluate the effects of a structured, video-supported educational program on adults in the community’s understanding and perceptions regarding stroke prevention and control.
The results indicated a significant enhancement in both factors following the intervention, with modifications statistically significant at the 1% level. This emphasizes the possibility of utilizing video-centered teaching techniques to improve public understanding of strokes.

The rise in mean knowledge scores from 7.37 to 17.4 indicates a substantial gain in participants’ understanding of stroke-related concepts, including symptoms, risk factors, and prevention. Similarly, the improvement in mean attitude scores by 20.49 points reflects a more positive and proactive orientation towards stroke prevention and early management.

These findings correspond with previous studies, like those conducted by Sharma and Reddy (2022)⁹^,¹²^,¹⁹^,²⁰, which observed notable enhancements in understanding after multimedia-driven health education in country communities. In the present research, the correlation after testing between knowledge and attitude was poor and unfavorable (r = -0.0994), indicating that improvements in knowledge might not always result in a change of attitude for everyone. This may be affected by elements like cultural values, individual experiences, and societal standards¹³^,¹⁸^,²⁰.

An important observation was the uniform effectiveness of the intervention across different sociodemographic groups, including those without formal education (79% of the sample). The use of culturally adapted content in the local language likely contributed to this outcome, making the material more relatable and easier to comprehend.

Given the growing burden of stroke in India² and the critical role of prompt identification and effective care, such scalable, community-based interventions can form a vital component of a broader community health approach.

IMPLICATIONS:

· For Nursing Practice: Community health nurses have the opportunity to incorporate video-assisted teaching into outreach initiatives to enhance public awareness of stroke risk factors and warning signs, especially among populations with low literacy levels.

· For Nursing Education: Incorporating multimedia health education methods into nursing curricula will better equip future professionals for community-based health promotion.

· For Public Health Policy: Health authorities can adopt such interventions on a wider scale to improve health literacy and encourage preventive behaviors in the community.

RECOMMENDATIONS:

1. Replication of the study with a larger, more diverse sample to improve generalizability.

2. Conducting randomized controlled trials or comparative studies to validate findings and measure long-term effectiveness.

3. Exploring the integration of nurse-led health promotion with mobile health applications and telehealth platforms for broader outreach.

4. Evaluating the intervention’s impact on actual stroke incidence and health outcomes over extended follow-up periods.

CONCLUSION:

The results of the study demonstrate that a strategic, video-supported educational method substantially enhances both understanding and perspectives on stroke prevention and risk elements, and administration within grown-ups. The effectiveness remained steady throughout demographic segments, highlighting its flexibility in diverse community environments. This instructional approach shows significant potential for alleviating the impact of stroke by increased public consciousness. Additional research involving control groups and long-term follow-up are advised to evaluate lasting advantages.

ACKNOWLEDGEMENTS:

The authors express sincere gratitude to all the participants for their openness and zealous participation in this research. Gratitude is also extended to the panel of specialists who assessed and confirmed the research tools and provided insightful recommendations for enhancement.

REFERENCES:

1. World Health Organization. Global Stroke Factsheet. Geneva: WHO; 2023.

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Received on 16.08.2025 Revised on 04.09.2025

Accepted on 19.09.2025 Published on 25.10.2025

Available online from November 04, 2025

Asian J. Nursing Education and Research. 2025;15(4):193-197.

DOI: 10.52711/2349-2996.2025.00040

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

S. No	Level of Attitude	Pretest	Mean 7.37	SD 2.576	Post Test	Mean	SD
S. No	Level of Attitude	%			%	52.91	13.070
1	Poor (<50%)	67			22
2	Fair (50 – 75%)	33			19
3	Good (>75%)	0			59