Abstract Body: Stroke is one of the leading causes of death in Guatemala [1]. Previous data has indicated that differences regarding stroke mortality exist depending on geographical location, ethnicity, and educational level within Guatemala [2]. We sought to understand community-level knowledge, attitudes, and practices regarding stroke in the Tz’utujil Maya Community of Guatemala.

A total of 25 interviews were held in Spanish with one or more community members, through a snowball sampling method with the assistance of Tz’utujil interpreters as needed. Interviews were based on a predefined questionnaire based on the Kleinman explanatory model of illness [3]. Through these interviews, we sought to assess community members’ understanding of stroke, its causes, available treatments, and prevention. Demographic data was collected and recorded interviews were transcribed into Spanish and subsequently translated into English. Each interview was analyzed and coded by two reviewers based on a consensus-based coding framework.
Analysis of the collected data revealed several recurring themes. Most interviewees conveyed a belief that stroke is directly caused by psychosocial factors such as stress, negative family dynamics, and overthinking. Some interviewees attribute stroke to spiritual causes including witchcraft. Individuals oftentimes seek out natural remedies provided by traditional healers in addition to, or instead of, prescription medications. Lack of access to healthcare, based on cost and proximity to tertiary care, was independently mentioned by numerous community members. Most individuals reported that a person who suffered a stroke could have prevented his/her symptoms by avoiding stress. The majority of the interviewees did not stigmatize stroke themselves but said that other members of the community do stigmatize stroke. Overwhelmingly, community members enthusiastically said that they would be interested in learning more about how doctors can treat and prevent stroke.

Our research provides valuable insight into the understanding of stroke as well as related attitudes and practices within the Tz’utujil Maya community of Guatemala. Our findings serve as a blueprint for stroke education efforts within this community and can guide similar research in other low-resource settings. We firmly believe that education is essential to primary prevention of stroke as well as improved health outcomes.