Emergency Department-initiated Naltrexone for Alcohol Use Disorder: Association with Recidivism.

Stroke remains the leading cause of mortality and disability worldwide []. Although mortality rates for patients with acute ischemic stroke (AIS) have shown a downward trend, these patients continue to experience significant levels of disability and loss of disability‐adjusted life years (DALYs) [, ]. Reperfusion therapies, such as tissue plasminogen activator (tPA) and endovascular therapy (EVT), have demonstrated significant benefits for improving functional outcomes, but they are highly time‐sensitive [, , ]. Stroke patients are expected to arrive at the hospital within 4.5 h to be eligible for the tPA []. Nevertheless, delayed presentation to the hospital represents a significant barrier to the widespread application of tPA therapy in stroke care [, ], particularly in China, where a small percentage of AIS patients receive tPA [], contributing to persistently high stroke‐related disability and mortality in China []. Knowledge of stroke symptoms is only the first step; stroke action awareness, which involves recognizing stroke signs and taking appropriate action [], is critical for determining whether patients can benefit from life‐saving reperfusion therapies. A survey conducted in 2011 revealed that only 1 in 5 community residents in China could identify stroke symptoms and act appropriately []. To enhance stroke action awareness, the Stroke 1‐2‐0 tool was specifically developed for the Chinese population by adapting the FAST (Face, Arm, Speech, Time) acronym, which has been the standard in English‐speaking countries [, , ]. Since 2017, after the educational campaigns have been implemented to promote Stroke 1‐2‐0 [], there is limited data examining the prevalence and characteristics of community residents who lack awareness of these symptoms and emergency responses at the national level [, , ]. For instance, the FAST‐RIGHT study surveyed the stroke symptom awareness in early 2017 [, ]. Recent studies focused primarily on symptom recognition within specific urban or provincial populations []. Hence, the current status of stroke action awareness remains unclear at the national level. Furthermore, the relationship between sociodemographic and geographic factors and stroke action awareness remains largely unexplored in China, making such information crucial for identifying subgroups that require targeted educational efforts. Recent studies have indicated a higher incidence of stroke and mortality rates among adults residing in northern and western China [], regions commonly referred to as the “Stroke Belt” [, ], which is comparable to the U.S. “Stroke Belt” in terms of geographic, socioeconomic, and health‐system disparities. However, there are limited studies comparing stroke awareness among adults living in the Stroke Belt versus those in non‐Stroke Belt regions. Therefore, this study aimed to evaluate stroke action awareness—including recognition of symptoms and appropriate emergency responses—among community residents in China, comparing Stroke Belt and non‐Stroke Belt regions while accounting for various sociodemographic and geographic factors.