Under the direction of Kent State University College of Nursing alumna Jennifer (Sanner) Beauchamp, Ph.D., BSN ’96, RN, associate professor at Cizik School of Nursing at UTHealth Houston, R.Á.P.I.D.O., a groundbreaking and culturally relevant acronym was created to boost stroke awareness among Spanish-speaking Hispanic/Latino communities in the United States. The acronym was adopted by The American Stroke Association (ASA) and was debuted nationwide during the 2023 Hispanic Heritage Month celebration, which runs from mid-September to mid-October. According to the ASA, a division of the American Heart Association, stroke is the fifth-leading cause of death in the country, but the fourth-leading cause of death for Hispanic men, and the third for Hispanic women.
R.Á.P.I.D.O. stands for:
R - Rostro caído (face drooping)
Á - Álteración del equilibrio (loss of balance, or lack of coordination)
P - Pérdida de fuerza en el brazo (arm weakness)
I - Impedimento visual repentino (sudden vision difficulty)
D - Dificultad para hablar (slurred or strange speech)
O - Obtén ayuda, llama al 911 (get help, call 911)
The idea for the acronym came about while Beauchamp and her research team, Alejandra Castro, BSN, RN; Andrea Ancer Leal, DNP, RN; and Tahani Casameni, BBA, were working on a project to incorporate Spanish subtitles into an all-English educational video about stroke. The video showed an image of the updated English acronym, BE FAST (balance, eyes, facial drooping, arm weakness, speech difficulties, and time), which is used to help memorize the signs of a stroke.
“My research team, comprised of bi-lingual women from various Spanish-speaking countries, identified that the apparent value of the English stroke awareness acronym was getting lost in translation,” said Beauchamp, who asked if they could search the published literature and find a Spanish stroke acronym instead. “While we identified a Spanish acronym from Costa Rica, it did not cover all of the BE FAST signs and symptoms, nor did it include the urgency of time in the name itself. That is when we began working to create our own for the diverse Spanish-reading and -speaking population in the United States.”
In addition to publishing the video, originally created under the leadership of Dr. Mary Carter Denny, the project was presented at the American Association of Neurosciences Nurses Annual conference, where the research team emphasized the importance of culturally relevant stroke awareness education for individuals with limited English proficiency. Beauchamp explained that hospital systems and others interacting with Spanish-speaking communities began contacting her asking if they could incorporate the acronym into their education processes.
Realizing the significance of what they had created, Beauchamp’s undergraduate honor nursing student, Andrea Ancer Leal, presented R.Á.P.I.D.O. at an International Stroke Conference. The presentation led to an eventual collaboration with ASA to better understand R.Á.P.I.D.O. through a nationwide study targeting different densely populated Spanish-speaking communities.
“We needed to put this in front of Spanish-speaking individuals including those with limited English proficiency to see what they thought of the acronym,” said Beauchamp. “We wanted to understand if the acronym resonated with the community we were targeting.”
While organizing the nationwide study, another Spanish stroke acronym was published and a Spanish acronym ASA previously created were identified. One strong element of R.Á.P.I.D.O. compared to the other acronyms was the incorporation of the BE FAST signs of a stroke alongside the urgency to quickly call first responders. However, it was decided all three would be included in the study, with ASA determining which would be adopted for their national campaign. Beauchamp shared that her team felt instrumental in starting the conversation, and in the end, it didn’t matter so much which acronym was picked because they knew it was going to make a difference.
“When ASA selected R.Á.P.I.D.O., however, it was empowering to know this was an instrumental change that was led by a nurse scientist and included nursing students,” said Beauchamp. “At the bedside, nurses know their patients one-on-one and touch many lives that way, but in becoming a nurse scientist, I had hoped to create something that would touch hundreds and thousands of lives and potentially help people on a global scale, and this does just that.”
The feedback to the acronym has been a best-case scenario. Beauchamp explained her team has heard stories where loved ones were able to quickly identify a family member having a stroke and get them emergency help. Others have shared their gratitude to have resources now made available to a population that has felt overlooked. Additionally, other non-English speaking communities and individuals are beginning to contact Beauchamp and her team asking them to think about stroke acronyms in other languages.
“We have had neurologists and others from across the globe contact us. We are taking the approach of finding the easiest way to get stroke awareness information out to people. We do not want any barriers to people using the acronym,” said Beauchamp. “It is exciting. People are now mailing us magnets, posters and images of billboards they’ve created to target their Spanish-speaking communities.”
For Beauchamp, the personal aspect of this acronym came from her experience as a nurse.
“It’s easy to say, ‘well, I don't speak Spanish. This isn't my area.’ But there's a gap and someone needs to fill it. I can't turn away now that it's been put in front of me,” said Beauchamp. “As healthcare providers and nurse scientists, we are especially responsible for those who may not be represented or may not be able to necessarily speak for themselves.”
Through working closely with the Spanish-speaking population, Beauchamp now approaches research projects bilingually from the start.
“This experience has taught me to think more about the Hispanic/Latino culture because it’s not necessarily the same as what others experience or need,” said Beauchamp. “I am grateful to my creative and instrumental team, Andrea Ancer Leal, Tahani Casameni Montiel, and Alejandra Castro.”
For more information about R.Á.P.I.D.O. and stroke awareness, visit www.stroke.org/rapido. For more about UTHealth Houston’s history of R.Á.P.I.D.O., visit https://www.uth.edu/stroke-institute/resources/rapido-resources.
Image Captions:
R.Á.P.I.D.O. graphic, a groundbreaking and culturally relevant acronym created to boost stroke awareness among Spanish-speaking Hispanic/Latino communities in the United States. (Graphic by UTHealth Houston)
(From left) Andrea Ancer Leal, DNP, RN; Jennifer Beauchamp, PhD, RN, and Alejandra Castro, BSN, RN; and others created and developed R.Á.P.I.D.O., which has been adopted by the AHA/ASA. (Photo by David Sotelo/UTHealth Houston)