A community education program on atrial fibrillation: Implications of pulse self-examination on awareness and behavior

Objectives: We postulated that community groups with older demographics could be taught to find and characterize their pulse rhythm for the presence of an irregular pulse (IP), which may indicate atrial fibrillation, a major risk factor for stroke. Methods: We conducted 281 community group education sessions involving 6203 attendees. Awareness objectives were to demonstrate that: (1) group education was effective in establishing awareness that an IP may indicate atrial fibrillation; and (2) this message was retained at follow-up. Behavioral objectives were to: (1) assess ability of participants to find and characterize their pulse rhythm; (2) regularly monitor pulse rhythm; and (3) act with medical appropriateness upon detecting an IP. Results: Of 6203 attendees, 4322 were older than 50 years and consented to participate. Of these consenting participants, 73.2% found their radial pulse and 91% characterized the rhythm (regular, 72.1%; irregular, 11%; undetermined, 7.9%). Telephone follow-ups on 1839 participants were performed at 30 to 60 days to assess durability of message and action taken. At follow-up, 89.1% remembered that an IP is potentially a risk factor for stroke, and 70.3% had taken their pulse since the program. Of those who discovered a new IP, 38% sought medical assessment. Conclusion: Community education programs focusing on pulse self-examination are effective in improving awareness that an IP may be a surrogate indicator of stroke risk. Such programs may lead to improved awareness of atrial fibrillation, subsequent behavioral changes, and stroke prevention.