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Neurol."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> It is critical to identify factors that significantly impede the correct action of calling emergency medical service (EMS) in the high-risk population with a previous history of transient ischemic attack (TIA) and further explore the urban\u2013rural difference in China.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Participants with previous TIA from the China National Stroke Screening Survey and its branch study (FAST-RIGHT) were interviewed cross-sectionally (<jats:italic>n<\/jats:italic> = 2,036). The associations between the outcome measure of not calling EMS and multiple potential risk factors were examined, including demographic information, live (or not) with families, medical insurance type, urban or rural residence, awareness of stroke symptoms, annual personal income, presence of cardiovascular disease or risk factors, and stroke history in family members or friends. The sample was further stratified to explore the urban\u2013rural difference by their residency.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The proportion of not calling EMS was 36.8% among all participants with previous TIA, and these were 21.7 and 48.4% among urban and rural participants, respectively. Among rural participants, risk factors that were significantly associated with not calling EMS included primary school education [odds ratio (OR) 2.50, 95% confidence interval (CI) 1.89\u20133.33], living with family (OR 2.09, 95% CI 1.33\u20133.36), unaware stroke symptoms (OR 2.60, 95% CI 1.81\u20133.78), and low income (OR 1.57, 95% CI 1.19\u20132.07). Among urban participants, only low income was significantly associated with an increased risk of not calling EMS (OR 1.74, 95% CI 1.10\u20132.72).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Rural residents with previous TIA in China had a higher percentage of not calling EMS. Multiple risk factors have been identified that call for targeted intervention strategies.<\/jats:p>","DOI":"10.3389\/fneur.2020.620157","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T05:18:31Z","timestamp":1612415911000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk Factors Influencing Seeking Emergency Medical Service in Urban and Rural China Among Participants With a Previous Transient Ischemic Attack"],"prefix":"10.3389","volume":"11","author":[{"given":"Jing","family":"Yuan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guang-Liang","family":"Shan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng-De","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Peng","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Ying","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.1161\/01.STR.0000134416.89389.9d","article-title":"Stroke risk after transient ischemic attack in a population-based setting","volume":"35","author":"Lisabeth","year":"2004","journal-title":"Stroke."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2354","DOI":"10.1212\/WNL.0000000000001665","article-title":"Prevalence, knowledge, and treatment of transient ischemic attacks in China","volume":"84","author":"Wang","year":"2015","journal-title":"Neurology."},{"key":"B3","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1179\/1743132813Y.0000000204","article-title":"Factors associated with delayed presentation in patients with TIA and minor stroke in China: analysis of data from the China National Stroke Registry (CNSR)","volume":"35","author":"Wang","year":"2013","journal-title":"Neurol Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1161\/STR.0b013e318284056a","article-title":"Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"44","author":"Jauch","year":"2013","journal-title":"Stroke."},{"key":"B5","doi-asserted-by":"publisher","first-page":"S49","DOI":"10.1016\/S0140-6736(15)00630-3","article-title":"Prevalence of stroke in China: an epidemiological study based on the national stroke screening survey","volume":"386","author":"Li","year":"2015","journal-title":"Lancet."},{"key":"B6","unstructured":"The China National Stroke Screening Survey Guidelines"},{"key":"B7","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/S1474-4422(16)30283-6","article-title":"Stroke 1\u20132-0: a rapid response programme for stroke in China","volume":"16","author":"Zhao","year":"2017","journal-title":"Lancet Neurol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1136\/svn-2019-000324","article-title":"Changing the strategy and culture of stroke awareness education in China: implementing stroke 1\u20132-0","volume":"5","author":"Zhao","year":"2020","journal-title":"Stroke Vasc Neurol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1161\/STROKEAHA.118.023317","article-title":"Public awareness of stroke and the appropriate responses in China: a cross-sectional community-based study (FAST-RIGHT)","volume":"50","author":"Li","year":"2019","journal-title":"Stroke."},{"key":"B10","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1161\/CIRCULATIONAHA.116.025250","article-title":"Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480 687 adults","volume":"135","author":"Wang","year":"2017","journal-title":"Circulation."},{"key":"B11","doi-asserted-by":"publisher","first-page":"104066","DOI":"10.1016\/j.landusepol.2019.104066","article-title":"Urban-biased land development policy and the urban\u2013rural income gap: evidence from Hubei Province, China","volume":"87","author":"Wang","year":"2019","journal-title":"Land Use Policy."},{"key":"B12","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.habitatint.2015.03.002","article-title":"Is urbanization narrowing the urban\u2013rural income gap? 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