The Heart Attack Survival Kit (HASK) project is a prospective, randomized trial, testing the effectiveness of an intervention delivered door-to-door by firefighters to increase use of 911 and ingestion of aspirin for symptoms of acute myocardial infarction (AMI) among seniors in King County, Washington. Firefighters visited 24,582seniors in King County, Washington and delivered a Heart Attack Survival Kit. Another 24,191 senior households served as the control group. Outcomes of the program were measured by tracking 911 calls as well as survey data. This study reports on the results of the telephone survey with a random sample of seniors (N = 323) to assess their knowledge of and intentions to act during a heart emergency. Results of a logistic regression analysis showed that being female, be ing younger, and remembering the kit was significantly related to intentions to act appropriately to AMI symptoms. The results are discussed in terms of public education around AMI.
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References
1.
American Heart Association. (2002). Heart and stroke facts. Dallas, TX: Author.
2.
Armitage, C. J., & Conner, M. (2001). Efficacy of the theory of planned behaviour: A metaanalytic review. British Journal of Social Psychology, 40(4), 471-499.
3.
Barbash, I. M., Freimark, D., Gottlieb, S., Hod, H., Hasin, Y., Battler, A., et al. (2002). Outcome of myocardial infarction in patients treated with aspirin is enhanced by pre-hospital administration. Cardiology, 98(3), 141-147.
4.
Blohm, M., Hartford, M., Karlson, B. W., Karlsson, T., & Herlitz, J. (1994). A media campaign aiming at reducing delay times and increasing the use of ambulance in AMI. American Journal of Emergency Medicine, 12, 315-318.
5.
Blohm, M. B., Hartford, M., Karlson, B. W., Luepker, R. V., & Herlitz, J. (1992). An evaluation of the results of media and educational campaigns designed to shorten the time taken by patients with acute myocardial infarction to decide to go to hospital. Heart, 76, 430-434.
6.
Brown, A. L., Mann, N. C., Daya, M., Goldberg, R., Meischke, H., Taylor, J., et al. (2000). Demographic, belief, and situational factors influencing the decision to utilize emergency medical services among chest pain patients. Rapid Early Action for Coronary Treatment (REACT) study. Circulation, 102(2), 173-178.
7.
Collins, R., Peto, R., Baigent, C., & Sleight P. (1997). Aspirin, Heparin, and Fibrinolytic therapy in suspected acute myocardial infarction. New England Journal of Medicine, 20, 847-860.
8.
Dracup, K., Moser, D. K., Eisenberg, M. S., Meischke, H., Alonzo, A., & Braslow, A. (1995). Causes of delay in seeking treatment for heart attack symptoms. Social Science and Medicine, 40, 379-392.
9.
Eisenberg, M. J., & Topol, E. J. (1996). Prehospital administration of aspirin in patients with unstable angina or acute myocardial infarction. Archives of Internal Medicine, 156, 1506-1510.
10.
Eppler, E., Eisenberg, M. S., Schaeffer, S., Meischke, H., & Larsen, M. P. (1994). 911 and emergency department utilization for chest pain: Results of a media campaign. Annals of Emergency Medicine, 24, 202-208.
11.
Finnegan, J. R., Meischke, H., Zapka, J. G., Leviton, L., Meshack, A., Benjamin-Garner, R.et al. (2000). Delay in seeking care for heart attack symptoms: Findings from national focus groups. Manuscript submitted for publication.
12.
Fuster, V., Dyken, M. L., Vokonas, P. S., & Hennekens C. (1993). Aspirin as a therapeutic agent in cardiovascular disease. Circulation, 87(2), 659-675.
13.
Gaspoz, J. M., Unger, P. F., Urban, P., Chevrolet, J. C., Rutishauser, W., Lovis, C., et al. (1996). Impact of a public campaign on pre-hospital delay in patients reporting chest pain. Heart, 67, 150-155.
14.
Goff, D. C., Jr., Feldman, H. A., McGovern, P. G., Goldberg, R. J., Simons-Morton, D. G., Cornell, C. E., et al. (1999). Prehospital delay in patients hospitalized with heart attack symptoms in the United States: The REACT trial. Rapid Early Action for Coronary Treatment (REACT) study group. American Heart Journal, 138(6/1), 1046-1057.
15.
Goff, D. C., Jr., Sellers, D. E., McGovern, P. G., Meischke, H., Goldberg, R. J., Bittner, V., et al. (1998). Knowledge of heart attack symptoms in a population survey in the United States. The REACT trial. Archives of Internal Medicine, 158(21), 2329-2338.
16.
Goldberg, R. J., Steg, P. G., Sadiq, I., Granger, C. B., Jackson, E. A., Budaj, A., et al., (2002). Extent of, and factors associated with, delay to hospital presentation in patients with acute coronary disease (the GRACE registry). American Journal of Cardiology, 89(7), 791-796.
17.
Goldberg, R. J., Yarzebski, J., Lessard, D., & Gore, J. M. (2000). Decade-long trends and factors associated with time to hospital presentation in patients with acute myocardial infarction: The Worcester Heart Attack study. Archives of Internal Medicine, 160(21), 3217-3223.
18.
Gresham, R. (1994, March). Does EMS belong in the fire service? Emergency Medical Services, 47-55.
19.
Grim P. S., Feldman T., & Childers, R. W. (1989). Evaluation of patients for the need of thrombolytic therapy in the prehospital setting. Annals of Emergency Medicine, 18, 483-488.
20.
Hennekens, C. H., Dyken, M. L., & Fuster, V. (1997). Aspirin as a therapeutic agent in cardiovascular disease. A statement for healthcare professionals from the American Heart Association. Circulation, 96(8), 2751-2753.
21.
Hennekens, C. H., Jonas, M. A., & Buring, J. E. (1994). The benefits of aspirin in acute myocardial infarction. Still a well-kept secret in the United States. Archives of Internal Medicine, 154, 37-39.
22.
Herlitz, J., Blohm, M., Hartford, M., Karlson, B. W., Luepker, R., Holmberg, S., et al. (1992). Follow-up of a 1-year media campaign on delay times and ambulance use in suspected acute myocardial infarction. European Heart Journal, 13(2), 171-177.
23.
Ho, M. T., Eisenberg, M. S., Litwin, P. E., Schaeffer, S. M., & Damon, S. K. (1989). Delay between onset of chest pain and seeking medical care: The effect of public education. Annals of Emergency Medicine, 18, 727-731.
24.
Ho, M. T. (1991). Delays in treatment of acute myocardial infarction: An overview. Heart & Lung, 20, 566-570.
25.
Jaffy, M. B., Meischke, H., & Eisenberg, M. S. (1998). Prevalence of aspirin use among patients calling 9-1-1 for chest pain. Academic Emergency Medicine, 5(12), 11146-11149.
26.
Johnson, J. A., & King, K. B. (1995). Influence of expectations about symptoms on delay in seeking treatment during a myocardial infarction. American Journal of Critical Care, 4(1), 29-35.
27.
Lavrakas, P. J. (1987). Telephone survey methods: Sampling, selection and supervision (Applied Social Research Methods Series No.17). Newbury Park, CA: Sage.
28.
Leventhal, H., Nerenz, D. R., & Steele, D. J. (1984). Illness representations and coping with health threats. In A. Baum & J. Singer (Eds.). A handbook of psychology and health (pp. 219-252). Hillsdale, NJ: Lawrence Erlbaum.
29.
Luepker, R. V., Raczynski, J. M., Osganian, S., Goldberg, R. J., Finnegan, J. R., Jr., Hedges, J. R., et al., (2000). Effect of a community intervention on patient delay and emergency medical service use in acute coronary heart disease: The Rapid Early Action for Coronary Treatment (REACT) trial. Journal of the American Medical Association, 284(1), 60-67.
30.
Lundergan, C. F., Reiner, J. S., & Ross, A. M. (2002). How long is too long? Association of time delay to successful reperfusion and ventricular function outcome in acute myocardial infarction: the case for thrombolytic therapy before planned angioplasty for acute myocardial infarction. American Heart Journal, 144(3), 377-379.
31.
Marder, V. J., & Sherry, S. (1988). Thrombolytic therapy: Current status (second of two parts). New England Journal of Medicine, 318, 1585-1595.
32.
Meils, C. M., Kaleta, K. A., & Mueller, C. L. (2002). Treatment of the patient with acute myocardial infarction: Reducing time delay. Journal of Nursing Care Quality, 17(1), 83-89.
33.
Meischke, H., Durlberg, E. M., Schaeffer, S. S., Henwood, D. K., Larsen, M. P., & Eisenberg, M. S. (1997). “Call Fast, Call 911”: A direct mail campaign to reduce patient delay in acute myocardial infarction. American Journal of Public Health, 87, 1705-1709.
34.
Meischke, H., Eisenberg, M. S., Schaeffer, S. M., Damon, S. K., Larsen, M. P., & Henwood, D. K. (1995). Utilization of emergency medical services for symptoms of acute myocardial infarction. Heart & Lung, 24(1), 11-18.
35.
Meischke, H., Eisenberg, M. S., Schaeffer, S., & Henwood, D. (2000). The “Heart Attack Survival Kit” project: An intervention designed to increase seniors’intentions to respond appropriately to symptoms of acute myocardial infarction. Health Education Research: Theory & Practice, 15(3), 317-326.
36.
National Institute of Health (NIH). (1997). Educational strategies to prevent prehospital delay in patients at high risk for acute myocardial infarction (NHLBI No. 97-3787). Bethesda, MD: Author.
37.
Page, J. O. (1990, December). Spotting hot trends in fire service EMS. Journal of Emergency Medical Services, 42-52.
Weaver, W. D., Eisenberg, M. S., Martin, J. S., Litwin, P. E., Shaeffer, S. M., Ho, M. T., et al. (1989). Prehospital thrombolytic therapy—MITI Project report on phase I: Feasibility, characteristics of patients. Journal of American College of Cardiology, 13, 152A.
40.
Yusuf, S., Collins, R., Peto, R., Furberg, C., Stampfer, M. J., Goldhaber, S. Z., et al. (1985). Intravenous and intracoronary fibrinolytic therapy in acute myocardial infarction: Overview of results on mortality, reinfarction and side effects from 33 randomized controlled trials. European Heart Journal, 6, 556.
41.
Zijlstra, F., Ernst, N., de Boerm M. J., Nibbering, E., Suryapranata, B., Hoorntje, J. C., et al. (2002). Influence of prehospital administration of aspirin and heparin on initial patency of the infarct-related artery in patients with acute ST elevation myocardial infarction. Journal of the American College of Cardiology, 39(11), 1733-1737.
