{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T15:24:14Z","timestamp":1771082654672,"version":"3.50.1"},"reference-count":21,"publisher":"Scientific Scholar","license":[{"start":{"date-parts":[[2019,12,12]],"date-time":"2019-12-12T00:00:00Z","timestamp":1576108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"World Federation of Neurology Grant 2016 LOI"},{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research, India","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["ruralneuropractice.com"],"crossmark-restriction":true},"short-container-title":["JNRP"],"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p>\n<jats:bold>Background<\/jats:bold> Stroke is one of the leading causes of disability-adjusted life years and may be the leading cause of death in rural regions in India. We aim to train the ASHAs (Accredited Social Health activist) for nonpharmacological management of risk factors for secondary stroke prevention in rural India. We tested the hypothesis that focused, multicomponent, short-term training on secondary prevention of stroke enhances the knowledge of ASHAs about risk factor management.<\/jats:p>\n<jats:p>\n<jats:bold>Objectives<\/jats:bold> To test the hypothesis that focused, multicomponent, short-term training on secondary prevention of stroke enhances the knowledge of ASHAs about risk factor management.<\/jats:p>\n<jats:p>\n<jats:bold>Materials and Methods<\/jats:bold> This study is part of the ASSIST trial (Training ASHA to Assist in Secondary Stroke Prevention in Rural Population). The study design is quasi-experimental (pretest and posttest). Culturally appropriate and pragmatic training material was developed by the study team. Three focused group training sessions were conducted in Sidhwan Bet and Pakhowal blocks of Ludhiana district, Punjab.<\/jats:p>\n<jats:p>\n<jats:bold>Results<\/jats:bold> A total of 274 ASHAs from 164 villages with mean \u00b1 SD age of 39.5 \u00b1 7.6 years participated in the three training sessions. The perceived knowledge of stroke risk factors and blood pressure assessment was 67.5 \u00b1 18.3% and 84.4 \u00b1 16.7%, respectively. The objective baseline knowledge about stroke prevention and management among ASHAs was lower 58.7 \u00b1 19.7% compared with perceived knowledge (<jats:italic>p<\/jats:italic> = 0.04). This increased to 82.5 \u00b1 16.36% (<jats:italic>p<\/jats:italic> &lt; 0.001) after the mop-up training after a mean of 191 days. More than 30% increment was seen in knowledge about the stroke symptoms (35.9%, <jats:italic>p<\/jats:italic> &lt; 0.001), avoiding opium after stroke for treatment (39.5%, <jats:italic>p<\/jats:italic> &lt; 0.001), causes of stroke (53.3%, <jats:italic>p<\/jats:italic> &lt; 0.001), modifiable risk factors for stroke (45.4%, <jats:italic>p<\/jats:italic> &lt; 0.001), and lifestyle modifications for stroke prevention (42.1%, <jats:italic>p<\/jats:italic> &lt; 0.001).<\/jats:p>\n<jats:p>\n<jats:bold>Conclusions<\/jats:bold> Focused group training can help enhance the knowledge of ASHAs about stroke prevention and management. ASHAs are also able to retain this complex multicomponent knowledge over a 6-month period. ASHA may be able to partake in reducing the secondary stroke burden in rural India.<\/jats:p>","DOI":"10.1055\/s-0039-3399396","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T00:18:05Z","timestamp":1576196285000},"page":"592-598","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Multicomponent Short-Term Training of ASHAs for Stroke Risk Factor Management in Rural India"],"prefix":"10.25259","volume":"10","author":[{"given":"Maneeta","family":"Jain","sequence":"first","affiliation":[{"name":"Department of Neurology, Christian Medical College, Ludhiana, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeyaraj","family":"Pandian","sequence":"additional","affiliation":[{"name":"Department of Neurology, Christian Medical College, Ludhiana, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clarence","family":"Samuel","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Christian Medical College, Ludhiana, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shavinder","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Christian Medical College, Ludhiana, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepshikha","family":"Kamra","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Christian Medical College, Ludhiana, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahesh","family":"Kate","sequence":"additional","affiliation":[{"name":"Department of Neurology, Christian Medical College, Ludhiana, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2019,12,12]]},"reference":[{"key":"10.1055\/s-0039-3399396\/ref-1","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.1016\/S0140-6736(17)32804-0","article-title":"India State-Level Disease Burden Initiative Collaborators. Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study","volume":"390","author":"Dandona","year":"2017","journal-title":"Lancet"},{"issue":"7","key":"10.1055\/s-0039-3399396\/ref-2","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1161\/STROKEAHA.115.008918","article-title":"Stroke is the leading cause of death in rural Gadchiroli, India: a prospective community-based study","volume":"46","author":"Kalkonde","year":"2015","journal-title":"Stroke"},{"issue":"2","key":"10.1055\/s-0039-3399396\/ref-3","doi-asserted-by":"crossref","first-page":"142","DOI":"10.4103\/0028-3886.156274","article-title":"Distribution of neurologists and neurosurgeons in India and its relevance to the adoption of telemedicine","volume":"63","author":"Ganapathy","year":"2015","journal-title":"Neurol India"},{"issue":"4","key":"10.1055\/s-0039-3399396\/ref-4","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1136\/svn-2017-000088","article-title":"Risk factors associated with 90-day recurrent stroke in patients on dual antiplatelet therapy for minor stroke or high-risk TIA: a subgroup analysis of the CHANCE trial","volume":"2","author":"Wangqin","year":"2017","journal-title":"Stroke Vasc Neurol"},{"key":"10.1055\/s-0039-3399396\/ref-5","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/S0140-6736(16)30506-2","article-title":"INTERSTROKE Investigators. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study","volume":"388","author":"O\u2019Donnell","year":"2016","journal-title":"Lancet"},{"key":"10.1055\/s-0039-3399396\/ref-6","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1186\/1471-2458-14-924","article-title":"A cluster-randomized controlled trial to evaluate the effects of a simplified cardiovascular management program in Tibet, china and Haryana, India: study design and rationale","volume":"14","author":"Ajay","year":"2014","journal-title":"BMC Public Health"},{"key":"10.1055\/s-0039-3399396\/ref-7","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jns.2015.10.019","article-title":"Task-shifting training improves stroke knowledge among Nigerian non-neurologist health workers","volume":"359","author":"Akinyemi","year":"2015","journal-title":"J Neurol Sci"},{"issue":"1","key":"10.1055\/s-0039-3399396\/ref-8","doi-asserted-by":"crossref","first-page":"e0145634","DOI":"10.1371\/journal.pone.0145634","article-title":"Task shifting the management of non-communicable diseases to nurses in Kibera, Kenya: does it work?","volume":"11","author":"Some","year":"2016","journal-title":"PLoS One"},{"issue":"1","key":"10.1055\/s-0039-3399396\/ref-9","first-page":"1","article-title":"Training nurses in task-shifting strategies for the management and control of hypertension in Ghana: a mixed-methods study","volume":"17","author":"Gyamfi","year":"2017","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"10.1055\/s-0039-3399396\/ref-10","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s12889-016-2891-6","article-title":"DISHA Study Investigators. 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