The Effectiveness of Knowledge Transfer Program in the Community to Improve the Health Service Accessibility for Acute Stroke

Abstract

Objective: To study the effectiveness of a knowledge transfer program in the community aimed at improving health service accessibility for acute stroke in terms of cognition and confidence among Village Health Volunteers (VHVs) in knowledge transfer to the community, access to emergency medical services, and timely access to health services. Methods: This research utilized a quasi-experimental, one-group pre-test/post-test design in the area of Bangchak Subdistrict, Phra Pradaeng District, Samut Prakan Province, between April 4 and October 10, 2024. The population included 50 VHVs and 100 inhabitants. VHVs received knowledge and then transferred it to the inhabitants. Data were collected via pretests and posttests, with changes in scores analyzed. A paired t-test was used to assess the effectiveness of the knowledge transfer program in the community to improve health service accessibility for acute stroke in terms of cognition and confidence among VHVs in knowledge transfer to the community. Data on patients with acute stroke were collected from electronic medical records, and chi-square test statistics were employed to analyze changes in the proportion of patients who arrived on time and the patients who used emergency medical services before and after the program implementation. Results: According to the study of the program's effectiveness in 50 VHVs and 100 inhabitants, it was found that the mean posttest score regarding stroke and health service accessibility for acute stroke among VHVs increased by 2.22 points (95%CI 1.73-2.71, p<0.001). The mean posttest score regarding stroke and health service accessibility for acute stroke among inhabitants increased by 3.29 points (95%CI 2.96-3.62, p<0.001). The mean posttest score regarding confidence in knowledge transfer and primary assessment of stroke among VHVs increased by 6.32 points (95%CI 5.15-7.49, p<0.001). Regarding patients with acute stroke in the Bangchak Subdistrict area, the proportion of patients treated at Bangchak Hospital within 4.5 hours increased from 0% to 55.6% after the program implementation (p = 0.006). Furthermore, the proportion of patients using emergency health services increased from 10% to 33.3% (p = 0.213). Conclusions: With the use of a knowledge transfer program in the community to improve health service accessibility for acute stroke, knowledge of stroke and health service accessibility for acute stroke among VHVs and inhabitants increased significantly. Additionally, confidence among VHVs in knowledge transfer and primary assessment of stroke also increased significantly. The number of patients with acute stroke receiving timely treatment showed a statistically significant increase, and an increase in patients who used emergency health services was also found.