News
2021; Lippincott Williams & Wilkins; Volume: 43; Issue: 9 Linguagem: Inglês
10.1097/01.eem.0000791908.24578.4f
ISSN1552-3624
Autores Tópico(s)Acute Ischemic Stroke Management
Resumostroke, health literacy, social justice: The cover of a comic book from Hip Hop Public Health teaching children how to recognize and respond to stroke in their elders.Hip Hop Stroke seems like an incongruous name for an organization teaching young people about a serious subject like stroke. But that's only until you realize that it uses music to inspire children to teach their families about the symptoms of a cerebrovascular accident and what to do if one occurs. The National Institute of Neurological Disorders and Stroke liked the idea too, funding the program and a trial that found children were able to build their parents' knowledge about stroke. That study taught children to educate their elders, raising the number of parents able to identify the five cardinal stroke symptoms from three (3.9%) before the program to 21 (29.6%) after. Knowledge of the FAST mnemonic also improved from two parents (2.7%) before the intervention to 29 (41%) after. (Stroke. 2012;43[1]:163; https://bit.ly/31fVl39.) “One of the things that we haven't done very well in public health is culturally tailor messages so they resonate with these communities,” said Olajide Williams, MD, the founder of HHS and Hip Hop Public Health, an organization of educators, entertainers, and health professionals that uses music to foster health literacy and equity among urban minority children and their families. “When we do not culturally tailor messages and then say, ‘Hey, they don't get it,’ the fault lies with us and not them. We need to speak a language they understand in all its cultural nuances and meet them where they are.” It is essential to use cultural adaptation frameworks to create messages to particular communities. Hip Hop Stroke seeks to increase stroke treatment rates among African Americans because of this group's low treatment rates and disproportionately high stroke fatality rates, said Dr. Williams, also the chief of staff for neurology, the director of acute stroke services, and a professor of neurology at Columbia University. What It Is Dr. Williams and Ewelina M. Swierad, PhD, said HHPH's multisensory health education model focuses on diverse communities, building on a model that “highlights important social and ecological influences on health behavior.” (Int J Environ Res Public Health. 2019;16[5]872; https://bit.ly/3rjEfvM.) That model takes into account art and its innovation and creativity, cultural tailoring, and evidence-based science, integrating “unconventional strategies, such as leveraging culturally tailored artistic materials in the form of storytelling, music, animation, film, [and] gamification, among others.” Dr. Williams has succeeded in reaching vulnerable populations though his research and HHPH, reducing delays in calls to 911 for stroke victims. HHPH programs have also addressed public health issues such as community immunity (via a rap anthology about vaccines), handwashing, masks, and fitness. HHS is now being disseminated in New York in partnership with the New York State Department of Health; 47 hospitals and schools in Chicago, St. Louis, Cincinnati, Chattanooga, Austin, Dallas, San Francisco, and Las Vegas have adopted it as well, Dr. Williams said. He noted that some HHS and HHPH videos could also be played in emergency departments and other hospital waiting rooms as well as in airports, train stations, bus stations, and other public places. “We believe that this would be a tremendously helpful way to increase stroke awareness,” Dr. Williams said. “Engaging public places with these health promotion videos is in the public interest, and will help advance health literacy.” A three-hour HHPH program presented in schools teaches children to act as first responders by immediately calling 911 when witnessing a stroke and to share stroke information with their parents and grandparents. The program also presents the “time is brain” message in a video game in which children navigate a spaceship within a human artery to shoot down blood clots. Dr. Williams works with recording artists and producers such as Doug E. Fresh and Darryl McDaniels, better known as D.M.C. from the hip-hop group Run-D.M.C., to create colorful, energizing multimedia to present evidence-based information. (https://bit.ly/3segSoF.) Several videos are also on YouTube, including “Stroke Ain't No Joke” (https://bit.ly/3diYdC3), “Keep Your Brain Healthy” (https://bit.ly/3lOTgo0), and “20 Segundos O Más” (https://bit.ly/3vYjqJK), which is in Spanish. The randomized controlled trial Dr. Williams led showed that the HHS program succeeded in helping children educate their parents and grandparents about stroke symptoms. (J Stroke Cerebrovasc Dis. 2018;7[11]:3187; https://bit.ly/2QAJ07A.) Several children even called 911 when faced with an elder having a stroke, and one of them actually overruled a parent's wait-and-see approach. Why It Has Been Successful Dr. Williams summed up HHPH's mission best in an appearance on “PBS NewsHour” earlier this year about increasing vaccination: “[H]ow do you communicate ... to a community that is bogged down with the daily hustle of survival? How do you communicate a stroke message to that community? And that was the challenge.” “We have always been able to use music as a way to reach people in ways that politics and religion can't,” said Mr. McDaniels of Run-DMC, who also appeared on “PBS NewsHour.” “The Black community is not trustful of our government. So, we figure, if people in the Black community especially could see somebody that looks like them, that sounds like them, that has walked the walk and also talked the talk, they will say, oh, if this is DMC, maybe it's OK for me to go get the shots, so that things could be better for all of us. The song is just the bait, so we can educate.” (https://to.pbs.org/3cjlUe8.) Share this article on Twitter and Facebook. Access the links in EMN by reading this on our website: www.EM-News.com. Comments? Write to us at [email protected]. Mr. Kirschwrites on medicine and health for multiple audiences, focusing on clinical medicine, communication in health care, policy, and health disparities. He is a past president of the Metro NY chapter of the American Medical Writers Association.
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