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       I.          Abstract

In New Zealand stroke is a major cause of death, disability and healthcare expenditure.  The most effective way of minimizing damages resulting from stroke is early recognition. Since 2007, the stroke Foundation of New Zealand has adopted FAST approach in increasing public awareness of stroke symptoms. The FAST approach advocated for assessment of facial weaknesses, arm weakness, speech disturbance, and advises of time to take appropriate action to reduce adverse effect of stroke. Nevertheless, the 2011 annual report on stroke awareness campaign shows little progress have been made on public awareness on early recognition of stroke symptoms. The study aims to identify best ways to maximize public awareness of the FAST message.  The study will use both qualitative method and quantitative method. Questionnaire and interviews will be used for collecting data from the selected participants. The study is targeting to obtain information from New Zealanders aged 25 years and above.  Descriptive analysis of the data will be done to provide relevant information that can be used to make a conclusion, recommendation, and future decision making.  The study will help in reducing the damages of stroke by saving lives, and improving treatment outcome

    II.          Background and Problem Definition

Stroke is the third cause of death, disability and healthcare expenditure in New Zealand (Feigin, Krishnamurthi, Barber, & Arroll, 2014). Stroke is defined as a sudden interruption of flow of blood to part of the brain leading to damages of brain cells and eventually the part of the brain stop working (Feigin, & Krishnamurthi, 2011). About 2500 people die every year as a result of the stroke, and a significant number of stroke victims are left with some form of disabilities. The most affected people by stroke are adults aged 65 years and above accounting for nearly 90% (Feigin, Krishnamurthi, Barber, & Arroll, 2014). People with suffering from high blood pressure and obesity are at a high risk of getting stroke than those without high blood pressure.

Although stroke is highly preventable, a large number of New Zealanders continue to suffer from stroke. The high rate of stroke is attributed to lack of awareness of stroke signs and symptoms as well as lack of emergency services that can increase stroke prevention and minimize its damage. Most of the people in New Zealand can’t recognize the signs of stroke occurring and only they realize when it is too late. Conversely, among those individuals who recognize early symptoms of stroke occurring, they lack access to emergency stroke service hospitals, and hence they suffer severe damage before they access the medication.

Stroke Foundation of New Zealand is a national health organization established with an aim of reducing incidences of stroke, save lives, improve treatment outcomes and provide support for those affected by stroke (Feigin, Krishnamurthi, Barber, & Arroll, 2014). In reducing incidences of stroke and saving lives, the foundation carries out public awareness campaigns for stroke risk factors as well as how to recognize early symptoms of stroke. The foundation educates the public on factors that increase the risk of having stroke and also teach them how they can prevent themselves from stroke. Additionally the foundation teaches the public on how to assess early sign and symptoms of stroke and take appropriate action. On improving treatment outcomes, the foundation focuses on health service delivery by improving acute and rehabilitation hospital services. Zeng, Mellon, Hickey, and Williams (2012) state that seeking treatment at early stages of stroke improves treatment outcomes and hence advocates for individuals to take immediate action if they detect signs of stroke. (March, 2011).

According to Burgess, et al., (2012), the most effective way of minimizing damage from stroke is early recognition. The Stroke Foundation of New Zealand has adopted the FAST approach to stroke symptoms recognition as a way of reducing the strokes deaths and disabilities among New Zealanders. Prompt action on stroke symptoms can save lives, improve recovery, and reduce medical expenditure from strokes. The FAST (face, arms, speech, and time) approach helps to recognize early symptoms and respond faster by calling an emergency service number (March, 2011). Some of the signs and symptoms of stroke detected by FAST approach include face dropping on one side, arm weakness on one side, and loss of speech or slurred speech. The Stroke Foundation has provided an emergency service number for people to call if they detect early signs of stroke.

The FAST campaign was started in 2007 with an aim of increasing public awareness of stroke-related symptoms. Prior to the campaign about 40% of New Zealanders could not correctly recognize symptoms of stroke and, as a result, most people could not realize they have stroke until it was too late. Therefore, the number of deaths and disabilities were on the rise. The Fast campaign used mass media leaflets poster, wallet cards, and fridge magnets to deliver the FAST message to a wide range of audiences in New Zealand. The FAST message advocated for assessment of facial weaknesses, arm weakness, speech disturbance, and advises of time to take appropriate attention to reduce adverse effect of stroke (Zeng, Mellon, Hickey, & Williams, 2012).

Although, the New Zealand Foundation have been promoting  the FAST campaign to increased public awareness of stroke recognition symptoms and quick response in case they detect stroke,  the 2010 report on stroke awareness showed no improvement in the levels of public understanding of stroke symptoms have been made since 2007. Therefore, there is need to establish a concrete strategy on how to increase public awareness of the FAST message to minimize damages from stroke. The 2010, stroke awareness campaign recommended that the FAST message campaign should be promoted through national media campaign as well as the use of fast materials such as posters, leaflets, and wallet cards among several others. Nevertheless, the campaign should develop other ways of increasing public awareness such as the use of social media to reach out more people (Te Ao, Brown, Feigin, & Anderson, 2012).

Thus, the main objectives of the study will be to find the best way to maximize public awareness of the FAST message. The study also aims at developing a viable means of establishing such awareness campaigns in a setting where funding and sponsorship to promotional campaign are scarce. In the course of the study, the researcher will answer the following main question; what is the best way to maximize public awareness of the FAST message?

 III.          Research Methodology

The section provides an overview of how the research methodology that will be applied in the study to answer the research questions.

Research Method

The study on raising the public awareness of stroke symptoms in New Zealand will use both qualitative and quantitative research method. Qualitative research design requires the research to collect data from previously conducted studies, peer-reviewed journals, books, and internet sources among others (Kothari, 2011). In this study, the available literature on stroke awareness in New Zealand will be reviewed to formulate the basis for the study. The qualitative research method gives a detailed explanation of the current stroke awareness in the country using the available information. The available literature will help the researcher to identify the gap that exists on how to raise public awareness of stroke symptoms in New Zealand. The available data will also help the researcher to define research question that will be answered in the course of the study. The method will use questionnaires and survey to collect relevant information from the selected participants of the study.

On the other hand, the quantitative study involves the researcher going to the field and collecting raw data from primary sources (Kothari, 2011). The data collected is based on the research question formulated at the beginning of the study. In this study, the researcher will collect primary data with an aim of identifying new ways of raising the public awareness of stroke symptoms in New Zealand. The collected data will be coded into numerical value to be analyzed statistically. The quantitative research method is considered more effective since it ensures accuracy of the study result.

Research Design

The study will employ descriptive research design. Descriptive research involves describing things as they are by identifying characteristics of the subject being studied (Kothari, 2011). The research design will use observation, interviews and survey to collect relevant information for the study. The analysis of the collected data will also try to explain the new ways of improving stroke awareness in New Zealand through FAST message.

 IV.          Sample Selection, Data Collection, and Data Analysis

The section describes how the study to find best ways to maximize public awareness of the FAST message in New Zealand will be conducted. The section describes the target population of the study and sample selection techniques to be used to obtain the sample. The section will also describe how data will be collected and analyzed.

The Target Population, Sample Size, and Sampling Technique

The population is a set of individuals having homogenous observable characteristics (Flick, 2011).  The target population for the study on how to raise public awareness of stroke symptoms in New Zealand targets New Zealand citizens aged 25 years  and above who are at a high risk of having stroke. As noted, stroke is one of the leading causes of death and disability in New Zealand thus most New Zealanders are at a very high risk of being attacked by stroke. Although, everyone is prone to stroke attack, people aged above 65 years are at a very high risk than other age groups. However, stroke awareness campaign targets everyone in New Zealand and therefore adult aged 25 years, and above can participate in the study. The current population of individual aged 25 years and above in New Zealand is 3.5 million and will be involved in the study.

The researcher acknowledges that is practically impossible to involve every member of the target population in the study. As a result, sampling will be done to obtain a small number of participants that will represent the target population. The findings obtained from the defined sample will be generalized to the whole population. The study is anticipating using a sample of 200 participants selected from the target population. A sample size of 200 participants is appropriate for the study since it is easily manageable, and the findings can represent the whole population.

To obtain the desired sample, probability-sampling technique will be used. Probability sampling ensures that every individual in the target population has an equal chance to participate in the study. Specifically, random sampling method will be applied in the study. Random sampling involves selecting participants randomly across the country. A computer program will help in selecting participant’s locations. The advantage of using random sampling method in the selection of the sample is that it avoids biases in the selection. The method is also applicable to the large target population and cost effective to apply. However, there are various limitations with the method such as less accurate when a large population is used and time used to access some of the study areas.

Measurement methods and data collection methods

The study will use questionnaires and interviews as the data collection tools. Questionnaires will have a set of questions relevant to the objectives of the study that the participant is expected to fill.  The questionnaires will include two types of questions which are closed-ended questions and open-ended questions (Flick, 2011). Closed-ended questions require the participant to select an answer from a set of multiple choices available. Open-ended questionnaires require participants to give their opinion in relation to the question. Questionnaires will be distributed to the selected participant to fill at their convenience and later collected for analysis. The interview will involve research setting a set of questions that he or she will ask the selected participants. The questions will be used as a guide during the interview to enable the researcher to remain focused to the study topic. The appointment will be made earlier with the participants to enable them to prepare and attend the interview at their convenience. During the interview process, the researcher will take notes on the participant response for future reference.

Both questionnaires and interviews will include the following research questions:

  1. What is stroke?
  2. What are the signs and symptoms of stroke?
  3. How can you respond if you detect stroke signs in your partner?
  4. How did you become aware of the FAST message?
  5. How to maximize public awareness of the FAST message?

Prior to the study, both questionnaires and interview guide will be tested for validity and reliability. Validity test involves testing the extent to which a data collection tool measures what is supposed to measure. In this study, the questionnaires and interviews are supposed to measure public awareness of stroke symptoms and identify ways to increase stroke awareness. Various validity tests will be conducted such as face validity and construct validity test among others. Reliability refers to the extent to which a data collection tool is able to produce stable and consistent results. A reliable data collection tool should ensure consistent results if the test is repeated repeatedly (Flick, 2011).

To ensure validity and reliability of the data collection tools, a pilot study will be conducted. The pilot study will be conducted in Southland district in New Zealand, which will be excluded in the main study. The pilot study that will be conducted will help to detect any weaknesses in the data collection instruments and necessary improvement to be made. During the pilot study, questionnaire will be distributed randomly and then collected for analysis. Any discrepancies in the findings from the questionnaires will be addressed to improve both their reliability and validity (Flick, 2011).

Data Analysis

Data analysis involves breaking down the collected data with an aim of discovering useful information in relation to the study topic that can be used to make a viable conclusion, make recommendations and support decision making (Flick, 2011). In the study to identify the best way to maximize public awareness of the FAST message in New Zealand. Qualitative data analysis will be applied. Qualitative analysis will involve describing this as represented by the data collected in relation to the study question. Quantitative data obtained during the study will be analyzed statistically using computer aided programs such as Excel and SPSS for better understanding. The analyzed data will be presented in the form of notes, graphs, tables, charts and narratives where applicable.

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