Evaluating the Global Impact of Stroke Awareness Month: A Serial Cross-Sectional Analysis.

Introduction: Stroke is the second-leading cause of mortality in the world and ranks fifth in terms of causes of death in the United States. "Time is brain" when it comes to the detection and treatment of a stroke as it can reduce morbidity and disability in the long run. May is recognized as Stroke Awareness Month to involve the concerned stakeholders. The goal of this month is to raise public awareness of the risk factors for stroke and to minimize its occurrence. We, for the first time, evaluated the actual impact of this awareness campaign to formulate evidence-based recommendations to promote stroke awareness.

Methods: The total number of tweets posted in the month of May from 2014 to 2022 were extracted. The search queries used were "stroke awareness month OR stroke month OR #strokemonth OR #strokewarenessmonth" and "stroke OR #stroke". Social network analysis of the tweets was done to understand the context of posts. Network analysis provides the capacity to estimate complex patterns of relationships and gives insights into useful information about impact, reach, and interactions in an environment. The top 100 related hashtags, influencers, and keywords were extracted. Beyond social media usage, Google Trends web search analysis was done for the search term 'stroke awareness month' for interest by region of the last five years to get an overall idea of the internet search trends globally.

Results: Out of the total 989,935 tweets about stroke posted in May 2022, only 1.07% of the tweets were specific to Stroke Awareness Month. The mean and standard deviation of the percentage of targeted action from 2014 to 2022 have been 3.14% and 1.35%, respectively. Forty-five percent of the top users never collaborated with each other. On Google Trends analysis, the event had primary involvement from the United States and the United Kingdom. The event had very limited reach in other continents, especially in Asian and African countries.

Conclusion: Our estimates highlight the limited digital impact of Stroke Awareness Month globally. The use of social media should be promoted, particularly in developing countries, to provide reliable information and generate user involvement on a global scale. Findings from this study can be leveraged to inform future policies for stroke awareness campaigns that improve public and global health.