Nicol and Thrift Cincinnati, USA (Pancioli et al 1998) Cincinnati, USA (Kothari et al 1997) Newcastle, Australia (Yoon et al 2001b) Georgia, USA (Rowe et al 2001)a Cincinnati, USA (Schneider et al 2003)b Michigan USA (Reeves et al 2002)c Northrhine-Westfalian area, Germany (Weltermann et al 2000) Newcastle, Australia (Yoon et al 2001a) 17 States, USA (Greenlund et al 2003)d Open Open Open Open Open Open Open Closed Closed Table 2 Results of multivariate regression analyses for predictors of increased knowledge of stroke warning signs Predictors of increased knowledge of stroke warning signs/symptoms Higher Higher History History of Question Younger Female education income of hyper- Authors type age sex level level stroke tension Race (white) - - - - - - - - - - - - - - - = significant predictor of increased knowledge in multivariate analysis. = nonsignificant predictor of increased knowledge in multivariate analysis. - = factor not used in multivariate analysis. a Although the study included both open and closed questions, the regression analysis was only performed on the open-ended questions. b Respondents with age > 35 and < 75 had increased knowledge of warning signs. c Stroke knowledge was greater in those > 35 and lower in those aged 18–24. d The effect of age was for “middle-aged persons”; ie, this group had greater knowledge of stroke symptoms than all others. An individual’s level of education is likely to have some influence on knowledge of stroke warning signs, and this was included as a potential predictor of stroke warning sign knowledge in eight of the nine studies that included multivariate regression analysis. Only Kothari et al (1997) reported that there was no significant influence of education level on an individual’s stroke knowledge (see Table 2). Similar to age, higher education levels appear to have a positive influence on stroke knowledge. Rowe et al (2001) noted that there was a dose-response relationship between education and knowledge of stroke warning signs, with higher levels of education being associated with increased stroke knowledge. There appears to be little difference in knowledge of stroke warning signs between males and females. Pancioli et al (1998), Reeves et al (2002), and Schneider et al (2003) all reported greater knowledge of stroke warning signs among females, while no effect of gender was reported in the remaining studies (Table 2). Because of this lack of consistency between the findings of different studies, it is unclear whether or not there is a gender difference in knowledge of stroke warning signs. 142 Because of the well established differences in stroke incidence between different racial groups, “race” has been included in the regression analysis for knowledge of stroke warning signs in the studies conducted in the USA. There is conflicting evidence for racial differences in knowledge of stroke warning signs. Three studies (Kothari et al 1997; Pancioli et al 1998; Rowe et al 2001) reported no independent effect of race on knowledge of stroke warning signs, whereas others (Reeves et al 2002; Greenlund et al 2003; Schneider et al 2003) found that blacks had less knowledge of these signs and symptoms. These results are complicated by the fact that income level was not included in the regression analyses by some investigators, which may have influenced the findings. It is important to control for this factor because of the potential interaction between race and income. A history of stroke has also been included as a factor in the regression analysis of predictors of knowledge of stroke warning signs. Both Pancioli et al (1998) and Rowe et al (2001) found that history of stroke was a significant independent predictor of stroke knowledge, although each defined history of stroke differently. Pancioli et al (1998) Vascular Health and Risk Management 2005:1(2)