Knowledge, attitude, and practice toward stroke among university students in Saudi Arabia: a nationwide cross-sectional study

Introduction Stroke remains to be a primary cause of mortality and disability globally, imposing a significant economic burden. The incidence and fatality rates of stroke in Saudi Arabia have risen, potentially due to inadequate public awareness. University students represent a crucial group for targeted education and community-based preventive programs. This study sought to evaluate the knowledge, attitudes, and practices (KAP) on stroke among university students in Saudi Arabia and to identify parameters related to stroke literacy to guide future national awareness initiatives. Methods This nationwide cross-sectional study was conducted between January 5 and May 10, 2025, among undergraduate students from public and private universities located in the Eastern, Western, Central, and Southern regions of Saudi Arabia. Data was collected both online and in person using a validated, self-administered questionnaire assessing demographic characteristics, knowledge of stroke symptoms and risk factors, and attitudes and preventive practices. A total knowledge score (0–14) was computed, and univariate and multivariate linear regression analyses were performed to identify predictors of stroke knowledge. Results A total of 484 students participated (mean age 21.9 ± 4.1 years; 52.7% female). Health-related students constituted 41.7% of the sample. Overall, 77.9% had prior awareness of stroke, mainly from schools (34.1%) and the internet (32.9%). The mean knowledge score was 9.17 ± 2.8, reflecting moderate awareness. High blood pressure was the most recognized risk factor (85.1%), and neurological effects were the most identified consequence (73.8%). In multivariate analysis, female sex, health-related specialty, senior academic level, and personal or family experience with stroke were significant predictors of higher knowledge scores ( p < 0.05). Conclusion This study provides the first nationwide, multi-university assessment of stroke awareness among Saudi university students. Findings highlight moderate knowledge but inadequate preventive practices, emphasizing the need for structured educational programs and campus-based stroke literacy campaigns to improve early recognition and timely response across the country.