1 Mission 1 Million – Getting to the Heart of Stroke

1 Mission 1 Million – Getting to the Heart of Stroke was a global initiative set up to raise awareness of atrial fibrillation and its link to stroke. 

The initiative was supported by an Expert Panel of leaders in the field of atrial fibrillation and 48 patient and professional organizations including AntiCoagulation Europe, the Atrial Fibrillation Association, Arrhythmia Alliance and Stroke Alliance For Europe.

As part of the initiative, €1 million was made available to fund community-driven projects aiming to help prevent atrial fibrillation-related stroke around the world. Entries, submitted by individuals, patient and professional groups, and healthcare centers, were reviewed and shortlisted by the Expert Panel. A total of 32 winners were awarded a share of €1 million: 26 winners were selected by public vote and 6 were selected by the Expert Panel. 

The initiative was funded by Boehringer Ingelheim as part of its global commitment to improving disease awareness in atrial fibrillation.

The start of the initiative

The initiative began in 2010 when the Speak about AF Survey (www.speakaf.com) revealed that more education is needed about the link between atrial fibrillation and strokes, which are often devastating. At the time, Speak about AF was the largest survey conducted in people diagnosed with atrial fibrillation and the physicians who treat the condition. The survey showed that although 93% of physicians agreed that the risk of a stroke was the most serious threat for people with atrial fibrillation, 51% of people with the condition were not concerned about being at increased risk of stroke. 

1 Mission 1 Million – Getting to the Heart of Stroke was announced initially within the medical community at the European Society of Cardiology Congress in August 2010. 

Project submissions

Following the launch of the initiative, 184 project entries were received from 36 countries within four months. 

The entries were then reviewed against the initiative’s entry criteria by the Expert Panel, whose members included cardiologists and patient group leaders in the area of atrial fibrillation, all of whom have expertise in supporting people with the condition. 

Each entry proposed an approach to increase awareness of atrial fibrillation-related stroke within the community whether through research, screening programs or the creation of patient groups and websites. All entries were translated into nine languages to allow people from around the world to cast their votes. 

Public vote

In March 2011, members of the public were invited to vote for projects that they believed would make a difference in preventing atrial fibrillation-related strokes.

Word of the initiative was spread via the media, online advertising, Twitter, YouTube and Facebook, and entrants were encouraged to use social media and on- and off-line advertising to promote their individual projects. 

The online competition received two million votes globally, from 117 countries. All votes received were reviewed and validated by an organization which specializes in independent promotional and broadcast verification in order to make sure that the voting had not been manipulated. Prior to funding being awarded, winning projects also underwent checks on eligibility, compliance with Terms and Conditions, and accuracy of the information provided in their entry. 

Winner awards

The 32 winning projects, chosen by the public and the Expert Panel, were awarded a share of €1 million in August 2011, at a ceremony in Paris. Winners spanned the globe from Malaysia to Canada and included a range of individuals, patient and professional groups, and healthcare centers from 17 different countries. Types of winning projects ranged from free ECG screenings, to radio and TV broadcasts, to large-scale awareness events. Spain led the way with a total of five winners, followed by France and Germany with four winners each.

Example projects

• China: An online quiz assessing knowledge of atrial fibrillation and stroke, which contained 300 questions divided into ten game sessions. Performance-based prizes were awarded. 
• France: Two projects run by the Cabinet de Cardiologie:

• P.R.O.T.E.C.T. (acronym in French - Preserve Rate, Optimize Treatment, Evaluate blood pressure monitoring) – a project to detect, treat and monitor heart rate and blood pressure issues in order to more effectively prevent stroke. The goal was to empower patients by allowing them to monitor their own blood pressure and heart rate and provide notification through a computerized education program consisting of different modules.
• D.E.T.E.C.T. (acronym in French - Detect Tachycardia through Telecardiology) – a project to detect cardiac arrhythmia in at-risk, hypertensive patients of over 65 years of age by giving them an ECG monitor linked to a blood pressure self-measure for eight days. Data were analyzed in telecardiology, and the goal was to detect arrhythmias earlier on and to optimize blood pressure monitoring. (https://www.telecardio.fr/) 

• Germany: A symposium run by Sport-Gesundheitspark (https://www.sport-gesundheitspark.de/) and directed primarily at sports scientists and coaches with the goal that they communicate the connection between atrial fibrillation and stroke afterwards in their training groups. 
• Italy: Atrial fibrillation awareness booklets produced and mailed to cardiologists in Italy, Germany, Spain and Russia. (www.heartmail.eu)
• Malaysia: Atrial fibrillation screening in Malaysia to help create awareness and reduce the incidence of atrial fibrillation-related stroke.
• Mexico: An online course to raise awareness and measure the risk of developing atrial fibrillation. (https://faometro.inspvirtual.mx/)
• Peru: Door-to-door consultations and information for patients with atrial fibrillation.
• Singapore: A project which provided atrial fibrillation patients with educational tools and included feedback systems to answer their queries on atrial fibrillation management and stroke symptoms.
• Slovenia: Free of charge recreational and lifestyle activities run by the Slovenian Heart Foundation to raise awareness of atrial fibrillation and stroke prevention among all age groups, including electrocardiogram recordings and Quadrille dancing. (https://zasrce.si/clanek/i416/) 
• South Africa: A stroke risk assessment program run by the arrhythmia patient support group PACE (https://www.paceafrica.org.za/) and supported by a public relations campaign using key cardiologists on the radio and TV.
• Spain: An online health education program for patients with atrial fibrillation to help them take control and manage their illness. (https://www.pacienteexpertoanticoagulado.org/)

Additional activities

During 2012 and 2013, 1 Mission 1 Million – Getting to the Heart of Stroke introduced further activities to help prevent atrial fibrillation-related stroke, including:

• A petition to ensure atrial fibrillation is fully recognized as a serious condition and a risk factor for stroke. 
• A fundraising platform to help projects increasing awareness of atrial fibrillation and stroke, to raise funds through public donations. 
• A forum for the public to share their personal and professional stories of atrial fibrillation-related stroke.

Results of the initiative 

The initiative came to an end in December 2013, but winners continue to help prevent atrial fibrillation-related stroke through their ongoing efforts in the community. Towards the end it was estimated that more than 1.5 million people directly benefited from local projects, including more than 37,000 healthcare professionals and more than 220,000 patients. (www.heartofstroke.com).