Validation of a Community Worker Administered Stroke Symptom Questionnaire

Study Overview
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Brief Summary
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This is a validation study. A stroke symptom questionnaire will be adapted and translated into local language. Two community health workers will be trained in its administration. Their findings will be validated against assessment by two neurologists. The study hypothesis is that the chance corrected agreement between the community worker administered stroke symptom questionnaire and the assessment by neurologist based on history and physical examination is at least moderate.

Detailed Description
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Overall Objective: To translate, adapt and validate a stroke symptom questionnaire for identification of stroke symptoms by community health workers ( CHW) in a peri-urban Pakistani community Specific Aims: To translate and adapt a stroke symptom questionnaire for identification of stroke symptoms by community workers in a peri-urban Pakistani community To validate community workers administered stroke symptom questionnaire against assessment by neurologist in a peri-urban Pakistani community To determine the feasibility of utilizing community workers for identification of stroke patients in the community in terms of subject refusals and difficulty in understanding questions The study will be conducted at the community site of AMAN community health project in Ibrahim Hyderi. Community health workers will systematically select households and from them individuals meeting eligibility criteria will be interviewed. Community workers will administer stroke symptom questionnaire to them at their homes. Those unable to answer will have a surrogate answering for them. In the second part of the study, two neurologists will independently assess all individuals. The purpose of this would be to validate the findings of the community workers based on the stroke symptom questionnaire.

Official Title
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Adaptation and Validation of a Community Worker Administered Stroke Symptom Questionnaire in a Peri-urban Pakistani Community

Conditions
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Stroke

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women aged 40 and above Permanent resident of Ibrahim Hyderi All ethnicities Can answer for themselves or have a surrogate willing to provide necessary information. Surrogate is defined as one who lives in the same household as the individual, who is the primary caregiver and has access to the medical record / information of the patient. Willing to give written informed consent Exclusion Criteria: - Individuals refusing to participate in any of the two components of the study i.e. CHW interview or neurological assessment

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pakistani adults<br>Men and women aged 40 and above, residing in Ibrahim Hyderi (periurban Pakistani community) Consenting to Interview about stroke symptoms | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Validity | This was a validation study in which we calculated the sensitivity, specificity and predictive values for CHW administered questionnaire against assessment by two neurologists. We also assessed the chance corrected agreement (kappa) for the same. | Cross-sectional , All interviews within 4 Weeks ( CHW and Neurologist) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility | We assessed the feasibility of utilizing CHWs for stroke screening in terms of time taken to fill out questionnaire, difficulty in understanding questions and subject refusals | Cross sectional - All interviews within 4 weeks( CHW and Neurologists) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stroke, Validation, Community Health workers, stroke symptom questionnaire