Background: Stroke remains a leading cause of death and disability globally. Timely response is critical for optimal outcomes, yet delays persist due to low public awareness. The FAST Heroes campaign educates children (aged 5–9) to recognize stroke symptoms and act, with indirect reach to families via conversations and educational materials. Purposes: To evaluate changes in public awareness of stroke symptoms, preparedness, and modifiable risk factors following the national rollout of the FAST Heroes campaign in Iceland (~388,000 population). The campaign engaged over 4,000 children. The study also sought to identify key channels through which the public became aware of the campaign, including children, schools, media, and other sources. Methods: A stratified random sample, aged 20–70, from the Icelandic National Registry completed surveys pre-campaign (2023) and post-campaign (2025). Instruments included the Stroke Preparedness Questionnaire, the Stroke Efficacy Scale, and questions on knowledge of symptoms and risk factors. Exposure sources (child, school, media) were recorded. Response rates were 37.6% (n=935) and 38.1% (n=999), respectively. Results: Awareness of FAST Heroes increased significantly from 5% to 12% (p<0.001), especially among participants ≥45 years. Reports of hearing about the campaign from a child rose from 13.0% to 20.5%, and from school/preschool from 14.8% to 23.1%. Over 94% identified key symptoms (facial droop, slurred speech, arm weakness), and ~70% would call an ambulance in response to those symptoms. However, only 40% felt confident managing a stroke event. Stroke efficacy improved significantly between time points regarding confidence in describing stroke symptoms when calling the emergency line (p=0.01) and knowing what to do if someone is having a stroke (p<0.05). Awareness of hypertension as a stroke risk factor remained low (~21%) at both timepoints. Conclusions: This is the first study to demonstrate population-wide distribution and intergenerational ripple effects of the FAST Heroes campaign, showing how stroke awareness can spread from children into the broader public. The campaign improved symptom recognition and self-efficacy but revealed persistent gaps in risk factor awareness and confidence. Future campaigns should prioritize modifiable risk factors and include stroke preparedness metrics to support early response.
Klinke et al. (Thu,) studied this question.