Who listens to our advice? A secondary analysis of data from a clinical trial testing an intervention designed to decrease delay in seeking treatment for acute coronary syndrome

Riegel, B; Elmi, A; Moser, DK; McKinley, S; Meischke, H; Doering, LV; Davidson, P; Pelter, M; Baker, H; Dracup, K

Who listens to our advice? A secondary analysis of data from a clinical trial testing an intervention designed to decrease delay in seeking treatment for acute coronary syndrome

Riegel, B Elmi, A Moser, DK McKinley, S Meischke, H Doering, LV Davidson, P

Pelter, M Baker, H Dracup, K

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Publication Type:: Journal Article
Citation:: Patient Education and Counseling, 2011, 85 (2)
Issue Date:: 2011-11-01

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Field	Value	Language
dc.contributor.author	Riegel, B	en_US
dc.contributor.author	Elmi, A	en_US
dc.contributor.author	Moser, DK	en_US
dc.contributor.author	McKinley, S	en_US
dc.contributor.author	Meischke, H	en_US
dc.contributor.author	Doering, LV	en_US
dc.contributor.author	Davidson, P https://orcid.org/0000-0003-2050-1534	en_US
dc.contributor.author	Pelter, M	en_US
dc.contributor.author	Baker, H	en_US
dc.contributor.author	Dracup, K	en_US
dc.date.available	2011-01-07	en_US
dc.date.issued	2011-11-01	en_US
dc.identifier.citation	Patient Education and Counseling, 2011, 85 (2)	en_US
dc.identifier.issn	0738-3991	en_US
dc.identifier.uri	http://hdl.handle.net/10453/18633
dc.description.abstract	Objective: Prolonged prehospital delay in persons experiencing acute coronary syndrome (ACS) remains a problem. Understanding which patients respond best to particular interventions designed to decrease delay time would provide mechanistic insights into the process by which interventions work. Methods: In the PROMOTION trial, 3522 at-risk patients were enrolled from 5 sites in the United States (56.4%), Australia and New Zealand; 490 (N= 272 intervention, N= 218 control) had an acute event within 2 years. Focusing on these 490, we (1) identified predictors of a rapid response to symptoms, (2) identified intervention group subjects with a change in these predictors over 3 months of follow-up, and (3) compared intervention group participants with and without the favorable response pattern. Hypothesized predictors of rapid response were increased perceived control and decreased anxiety. Knowledge, attitudes, and beliefs were hypothesized to differ between responders and non-responders. Results: Contrary to hypothesis, responders had low anxiety and low perceived control. Only 73 (26.8%) subjects showed this pattern 3 months following the intervention. No differences in ACS knowledge, attitudes, or beliefs were found. Conclusion: The results of this study challenge existing beliefs. Practice implications: New intervention approaches that focus on a realistic decrease in anxiety and perceived control are needed. © 2011 Elsevier Ireland Ltd.	en_US
dc.relation.ispartof	Patient Education and Counseling	en_US
dc.relation.isbasedon	10.1016/j.pec.2011.01.016	en_US
dc.subject.classification	Public Health	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Patient Admission	en_US
dc.subject.mesh	Regression Analysis	en_US
dc.subject.mesh	Chi-Square Distribution	en_US
dc.subject.mesh	Health Knowledge, Attitudes, Practice	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Emergency Service, Hospital	en_US
dc.subject.mesh	Emergency Medical Services	en_US
dc.subject.mesh	United States	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	New Zealand	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Acute Coronary Syndrome	en_US
dc.title	Who listens to our advice? A secondary analysis of data from a clinical trial testing an intervention designed to decrease delay in seeking treatment for acute coronary syndrome	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	85	en_US
utslib.for	1110 Nursing	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	85	en_US

Abstract:

Objective: Prolonged prehospital delay in persons experiencing acute coronary syndrome (ACS) remains a problem. Understanding which patients respond best to particular interventions designed to decrease delay time would provide mechanistic insights into the process by which interventions work. Methods: In the PROMOTION trial, 3522 at-risk patients were enrolled from 5 sites in the United States (56.4%), Australia and New Zealand; 490 (N= 272 intervention, N= 218 control) had an acute event within 2 years. Focusing on these 490, we (1) identified predictors of a rapid response to symptoms, (2) identified intervention group subjects with a change in these predictors over 3 months of follow-up, and (3) compared intervention group participants with and without the favorable response pattern. Hypothesized predictors of rapid response were increased perceived control and decreased anxiety. Knowledge, attitudes, and beliefs were hypothesized to differ between responders and non-responders. Results: Contrary to hypothesis, responders had low anxiety and low perceived control. Only 73 (26.8%) subjects showed this pattern 3 months following the intervention. No differences in ACS knowledge, attitudes, or beliefs were found. Conclusion: The results of this study challenge existing beliefs. Practice implications: New intervention approaches that focus on a realistic decrease in anxiety and perceived control are needed. © 2011 Elsevier Ireland Ltd.

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http://hdl.handle.net/10453/18633