Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Judith L. Lichtman


Background: Heart attack and stroke are the leading causes of death in the U.S. Previous studies have suggested that women experience a different symptom set including more atypical symptoms compared to men and are also more likely to delay seeking treatment for acute symptoms. Ongoing national campaigns have been trying to raise awareness in women population and to reduce gender disparities. This study evaluated the effect of national campaigns by describing trends in awareness of heart attack and stroke short after the time many of the national campaigns were being introduced.

Methods: This was a cross-sectional study analyzing 2005 and 2009 Behavioral Risk Factor Surveillance Survey (BRFSS) data. Heart attack and stroke knowledge indicators were created for each participant from 13 heart attack and stroke symptom knowledge questions and were compared between 2005 and 2009. Relative change in knowledge between 2005 and 2009 was calculated for each indicator. Age and sex subgroup analyses were performed to examine patterns within subgroups, if relative change was greater than 10.0%.

Results: More than 80.0% of respondents could correctly name the 3 most commonly recognized heart attack symptoms and 3 most commonly recognized stroke symptoms in both years. However, less than 40% of respondents could correctly recognize all 5 heart attack symptoms and less than 50% of respondents could correctly recognize all 5 stroke symptoms in both years. The rates of awareness were similar in both years in most symptoms. The greatest increase was found in an atypical heart attack symptom: pain or discomfort in the jaw, neck, or back, with an increase rate equaling 17.8%. Age and sex subgroup analysis revealed the greatest increase in young women aged 18 to 34 years (29.1%).

Conclusions: The findings indicated that the overall knowledge of early warning signs and symptoms of heart attack and stroke was still not ideal, and there was room for improvement. The greatest increase was in the awareness of the heart attack atypical symptom among young women, which may be a positive sign of the nationwide efforts to raise awareness in women population and to reduce gender disparities.


This is an Open Access Thesis.

Open Access

This Article is Open Access