Evaluation of a Public Education Program Delivered by Firefighters on Early Recognition of a Heart Attack

Abstract

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 24,582 seniors 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, being 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.

Improving knowledge, attitudes and beliefs about acute coronary syndrome through an individualized educational intervention: A randomized controlled trial

“…The majority of previous interventions that targeted knowledge, attitudes and beliefs about ACS were underpinned by a theoretical framework [7,8,[16][17][18]20]. Five of these were based on Leventhal's Self-Regulatory Model of Illness Behaviour [7,8,[16][17][18]. As most of these researchers reported successful intervention outcomes [7,8,16,18], the use of Leventhal's Self-Regulatory Model of Illness Behaviour in this study substantiates the effectiveness of the intervention.…”

“…Theoretically-based education is considered superior to its non-theory based counterpart [34][35][36]. The majority of previous interventions that targeted knowledge, attitudes and beliefs about ACS were underpinned by a theoretical framework [7,8,[16][17][18]20]. Five of these were based on Leventhal's Self-Regulatory Model of Illness Behaviour [7,8,[16][17][18].…”

“…To be included in this study, an ACS diagnosis was a pre-requisite; a criterion which differed from previous studies, where inclusion criteria ranged from a diagnosis of coronary heart disease [7,8,14,18,19] to no diagnosis required [16,17,20].…”

“…To date, eight interventions aimed to improve knowledge, attitudes or beliefs about ACS [7,8,14,[16][17][18][19][20]. A summary of these interventions are outlined in Table 1.…”

Development of Systems of Care for ST-Elevation Myocardial Infarction Patients

“…There have been 3 randomized trials conducted in the past decade in North America that have demonstrated an increased use of 9-1-1 for MI: the "Call Fast, Call 911" campaign in King County, Wash 18 ; Rapid Early Action for Coronary Treatment (REACT) research program 12 ; and the "Heart Attack Survival Kit" project. 19 These intervention trials show that it is possible to increase EMS use for MI when (1) a fairly large quantity of mass media messages are disseminated throughout a community, (2) messages are targeted at high-risk audiences, (3) multipronged approaches are implemented that target many different stakeholders, and (4) interpersonal counseling sessions are conducted by credible sources. The results of these trials also show that it is difficult to develop an intervention that has a sustained effect over time.…”