The North Dakota Stroke System of Care

Stroke is the leading cause of long term care admissions in North Dakota. Being a rural state with an aging demographic, efforts began to educate North Dakota residents about the signs of stroke, as well as the importance of immediate care. Through leadership from the North Dakota Department of Health and a strong collaboration built with partner hospitals, Emergency Services providers, the American Heart Association, the Stroke System of Care public awareness and education campaign was launched.

The North Dakota Stroke System of Care was a public awareness and engagement campaign aimed at educating the public about the signs of stroke and build awareness about the need to act fast in the event of a suspected stroke. Efforts focused on increasing patient access to the most current evidence-based treatment options.

At-risk groups were the target audience including North Dakota adults 65 years of age and older, adults ages 45-64, including the children of older adults who may be caretakers or decision makers, and American Indians. The campaign used an integrated approach with an emphasis on public outreach to disseminate tailored messages.



Materials such as retractable banners, tabletop displays, and table tents were developed for the campaign to inform the public about what a stroke is, how to identify the signs of a stroke, designations of care facilities, and risk factors. These materials were displayed at hospitals, community centers, meetings, presentations, and senior assistance centers throughout the state.



Print collateral pieces were also developed in an effort to reach the public with distribution points across the state including doctor offices, pharmacies, assistance facilities, and care centers. Over eight thousand stroke posters were distributed throughout the state highlighting the sudden signs of stroke. A brochure was also designed and 20,000 were distributed by hospitals, clinics, health departments, senior centers, and assistance programs. Approximately 70,000 wallet cards blanketed the state promoting “Act FAST at the first sign of STROKE.” The majority of distribution was handled by the North Dakota Pharmacists’ Association who inserted wallet cards in prescription medication bags. Over 5,000 large magnets were distributed encouraging the public to dial 9-1-1 in the event of a suspected stroke. A bookmark was designed using the brain image and the “Act FAST at the first sign of STROKE” headline. Twenty-four thousand bookmarks were printed with primary distribution through the North Dakota Library Association. A placemat describing the sudden signs of stroke was distributed to 32,000 North Dakota residents through hospitals, care centers, senior centers, and the Meals on Wheels program. Vinyl decals were designed and distributed to facilities awarded a Stroke System of Care designations.



Banner and mobile ads were placed and targeted adults ages 35 and older, across the entire state of North Dakota. The targeting platform searched for relevant website content and the ads were placed on brand-safe web pages that matched the campaign message. Content targeting included health, arts and entertainment, weather and news sites. Ads were placed on both national and local sites, but were targeted to adults ages 35 and older, located in the state of North Dakota. Ads were placed across all platforms, including desktop computers, tablets and mobile phones and were all clickable to the campaign website at



News releases were developed in collaboration with the Department of Health and the Stroke System of Care Task Force to highlight the campaign’s launch, Stroke Awareness Month in May, and important education points from the campaign. A news release was also developed, reviewed, and distributed to introduce the Stroke System of Care and the involvement of some members of the Task Force at the International Stroke Conference held in Nashville, TN. Banik also drafted a state proclamation document and an associated press release to announce May as Stroke Awareness Month across the state of North Dakota. The Department of Health Public Information Officer was responsible for the final distribution of these materials.



Banik also provided public relations support to the North Dakota Department of Health, during the 2015 Stroke and Cardiac Conference. A media advisory, along with a comprehensive press kit were sent out to Bismarck area media prior to the conference. News coverage of the conference was excellent, resulting in stories on network, broadcast and online sources. Interview segments with a stroke survivor and with Dr. Ziad Darkhabani and Dr. Jeffrey Sather were included.

Partnerships with the North Dakota Library Association, the Stroke Network hospital group, the North Dakota Pharmacist’s Association, clinics and health departments allowed materials to be disseminated by trusted sources. The vinyl decals were successfully distributed to all hospitals who were accredited at the set designation levels as a way to visually represent their level of stroke care to community members. Once the campaign ended, Banik was contacted by the client to seek recommendations for continuing media placement and print distribution throughout the state.

Ink, Pixels, Work