2.1 Campaigns to encourage healthy lifestyles and risk factor awareness

Even though stroke is preventable, knowledge of the risk factors is poor (Bulgaria[87], Croatia[88], Denmark[89], Estonia[90], Germany[91], Greece[92], Ireland[93], Sweden[94]).

High blood pressure (hypertension) is the most commonly known risk factor. In a Greek study 66% named hypertension as a risk factor for stroke, but only 44% recognised smoking and 34% obesity as a risk factor[92]. In a Danish study, only few subjects recognised smoking or diabetes mellitus as major risk factors[89]. Importantly, only a small proportion of patients with risk factors consider themselves as being at high risk[88, 92].

Most countries have undertaken regional  or national educational campaigns aimed  at raising awareness of stroke risk factors and healthy lifestyles using a multi-media approach. These campaigns are often combined with campaigns to increase public knowledge of stroke symptoms and the appropriate response.

Events are held across most of Europe in connection with World Stroke Day (www.worldstrokecampaign.org) including multi-media campaigns; public lectures; and events/information stalls in public spaces like hospitals, shopping malls, or libraries (e.g. free pop-up blood pressure measurement points). These events are often organised by the regional or national SSOs.

Other examples are the Czech HOBIT Programme which aims to increase school children’s knowledge of stroke risk factors and symptoms (Chapter  3.1),  the  Belgian  annual  “Heart Rhythm Week” with free screening in hospitals and activities to raise awareness around atrial fibrillation[95], or the Finnish blood pressure campaign.

Example from Finland: The Finnish Brain Association ran a national blood pressure campaign, which was awarded a World Stroke Organisation prize in WSO prize winner 2016. The campaign used radio, social media, a website and digi- screens in trams and metros. The radio campaign reached 2.85 million Finns. 121 pop-up measurement points were set up and, 6,002 people’s blood pressure was measured.

Although many campaigns have been undertaken, very few have been evaluated systematically. The few campaigns that have been assessed showed varied success with regards to improved risk factor knowledge (Czech Republic: no effect[96], Germany: improved knowledge[91]) or, even more importantly, behaviour change[97].