INTRODUCTION:
Local public health institutions often face workforce limitations hindering direct resident contact. In T City, Republic of Korea, older adults face challenges accessing health institutions due to mobility and transportation constraints.1,2 These barriers restrict participation in health programs and timely information. This study evaluated the Stroke Informant program, using trained residents as messengers to improve stroke awareness and response among rural older adults.

METHODS:
From february to december 2025, four trained residents served as Stroke Informants, conducting door-to-door visits to rural households.3 They provided information on stroke symptoms and EMS utilization. Program efficacy was assessed via a telephone survey (november 28 to december 24 2025) and focus group interviews(FGIs) exploring informant and recipient experiences.4

RESULTS:
Among 1584 residents aged 60 and older in the target district, informants conducted 2693 activities. Excluding duplicate records, 844 unique individuals received stroke information via informants, and 400 (47.4) participated in the telephone survey. Recognition was highest for speech impairment (82.8) and lowest for headache (72.3). Stroke awareness was lower in residents aged 70 and older.5 Regarding behaviors, 93.5 intended to seek hospital care, 84.0 identified ambulance use, and 85.0 recognized the 3 hour golden time.6 FGIs showed both groups perceived activities as effective for symptom and response acquaintance, emphasizing repeated contact.

CONCLUSIONS:
Community health messengers are an effective strategy to overcome rural delivery barriers. While the program successfully improved health information accessibility, findings highlight the need for structured informant activity manuals and diversified materials to sustain repeated contact engagement.