TY - JOUR
T1 - Patient delay in seeking care for heart attack symptoms
T2 - Findings from focus groups conducted in five U.S. regions
AU - Finnegan, John R.
AU - Meischke, Hendrika
AU - Zapka, Jane G.
AU - Leviton, Laura
AU - Meshack, Angela
AU - Benjamin-Garner, Ruby
AU - Estabrook, Barbara
AU - Hall, Nancy Johnston
AU - Schaeffer, Sheri
AU - Smith, Cassandra
AU - Weitzman, Elissa R.
AU - Raczynski, James
AU - Stone, Elaine
N1 - Funding Information:
1This research was supported by grants from the National Heart, Lung & Blood Institute, National Institutes of Health, Bethesda, MD (U01 HL 53142, 54517, 53211, 53135, 53141, and 53149), and an educational materials grant from Genentech, Inc., San Francisco, CA.
PY - 2000
Y1 - 2000
N2 - Background. Patient delay in seeking health care for heart attack symptoms is a continuuing problem in the United States. Methods. Investigators conducted focus groups (N = 34; 207 participants) in major U.S. regions (NE, NW, SE, SW, MW) as formative evaluation to develop a multicenter randomized community trial (the REACT Project). Target groups included adults with previous heart attacks, those at higher risk for heart attack, and by-standers to heart attacks. There were also subgroups reflecting gender and ethnicity (African-American, Hispanic-American, White). Findings. Patients, bystanders, and those at higher risk expected heart attack symptoms to present as often portrayed in the movies, that is, as sharp, crushing chest pain rather than the more common onset of initially ambiguous but gradually increasing discomfort. Patients and those at higher risk also unrealistically judge their personal risk as low, understand little about the benefits of rapid action, are generally unaware of the benefits of using EMS/9-1-1 over alternative transport, and appear to need the 'permission' of health care providers or family to act. Moreover, participants reported rarely discussing heart attack symptoms and appropriate responses in advance with health care providers, spouses, or family members. Women often described heart attack as a 'male problem,'an important aspect of their underestimation of personal risk. African-American participants were more likely to describe negative feelings about EMS/9-1-1, particularly whether they would be transported to their hospital of choice. Conclusions. Interventions to reduce patient delay need to address expectations about heart attack symptoms, educate about benefits and appropriate actions, and provide legitimacy for taking specific health care-seeking actions. In addition, strategy development must emphasize the role of health care providers in legitimizing the need and importance of taking rapid action in the first place. (C) 2000 American Health Foundation and Academic Press.
AB - Background. Patient delay in seeking health care for heart attack symptoms is a continuuing problem in the United States. Methods. Investigators conducted focus groups (N = 34; 207 participants) in major U.S. regions (NE, NW, SE, SW, MW) as formative evaluation to develop a multicenter randomized community trial (the REACT Project). Target groups included adults with previous heart attacks, those at higher risk for heart attack, and by-standers to heart attacks. There were also subgroups reflecting gender and ethnicity (African-American, Hispanic-American, White). Findings. Patients, bystanders, and those at higher risk expected heart attack symptoms to present as often portrayed in the movies, that is, as sharp, crushing chest pain rather than the more common onset of initially ambiguous but gradually increasing discomfort. Patients and those at higher risk also unrealistically judge their personal risk as low, understand little about the benefits of rapid action, are generally unaware of the benefits of using EMS/9-1-1 over alternative transport, and appear to need the 'permission' of health care providers or family to act. Moreover, participants reported rarely discussing heart attack symptoms and appropriate responses in advance with health care providers, spouses, or family members. Women often described heart attack as a 'male problem,'an important aspect of their underestimation of personal risk. African-American participants were more likely to describe negative feelings about EMS/9-1-1, particularly whether they would be transported to their hospital of choice. Conclusions. Interventions to reduce patient delay need to address expectations about heart attack symptoms, educate about benefits and appropriate actions, and provide legitimacy for taking specific health care-seeking actions. In addition, strategy development must emphasize the role of health care providers in legitimizing the need and importance of taking rapid action in the first place. (C) 2000 American Health Foundation and Academic Press.
KW - Acute myocardial infarction
KW - Community campaigns
KW - Community trials
KW - Emergency medical care
KW - Focus groups
KW - Formative evaluation
KW - Heart attack
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U2 - 10.1006/pmed.2000.0702
DO - 10.1006/pmed.2000.0702
M3 - Article
C2 - 10964634
AN - SCOPUS:0033856602
SN - 0091-7435
VL - 31
SP - 205
EP - 213
JO - Preventive medicine
JF - Preventive medicine
IS - 3
ER -