Monday, 27 July 2015

Getting to the Heart of Public Health Campaigns

SPHPM’s Dr Janet Bray, Dr Lahn Straney and Professor Judith Finn have co-authored a paper with researchers from the Heart Foundation, Curtin University and the Alfred Hospital, exploring the reach and influence of a mass media campaign developed by the Heart Foundation, informing individuals of the warning signs of a heart attack.

In 2009, the Heart Foundation introduced the ‘Warning Signs of Heart Attack’ strategy which ran until 2013. The strategy incorporated social marketing campaigns to educate people in the community of the risks of heart attacks, better the knowledge of possible symptoms and warning signs, increase confidence of knowing what steps to take when an individual does experience the warning signs and better the chance that people would in fact contact an ambulance as a first response.

For individuals with acute coronary syndromes (ACS) medical treatments such as coronary revascularization are possible avenues to better the clinical outcomes of patients. However, this is based on when these interventions are implemented. Prehospital delays generally arise due to patients not being able to identify their symptoms or failing to take immediate action. Reviews have been conducted of the research surrounding the associated factors of prehospital delays and have noted that there are a diverse number of barriers, such as sociodemographic, cognitive and emotional, that lead to poor responses after the onset of ACS symptoms.

While there have been improvements in minimising the amount of in hospital time for individuals with ACS there is still a majority of patients who cannot reap the full benefit of these interventions due to critical delays in being presented to the hospital after the onset of symptoms.

The Warning Signs of Heart Attack campaign sought to raise awareness of some of the obstacles associated with not taking actions, such as ignoring of symptoms and lack of awareness of non-classic symptoms and being concerned that the event may have been a false alarm. Research has demonstrated that the use of mass media campaigns can better the knowledge of patients but there is limited research on the impact on patient behaviour. This study seeks to target this gap in knowledge through critique of the Heart Foundation campaign’s awareness through interviews with a group of ACS patients.

The hoped outcome of the campaign was that patients were able to rapidly identify their symptoms which may be associated with ACS and contact emergency medical services for immediate assistance and transport to a hospital. Evidence states that prehospital delay times have seen very few changes over the last ten years and less than half of patients being presented for ACS are failing to attribute their symptoms to the heart. Most of these patients have also not utilised the emergency medical service system.

One hundred and ninety nine semistructured interviews were held with ACS patients aged 35-75 years who were fluent English speakers. The questions asked were focused on the factors which can predict prehospital delays, their awareness of the campaign and whether they felt it increased their knowledge and as a result, influenced the actions undertaken. The researchers used multivariable logistic regression to determine the relationship between campaign awareness and a one hour delay in seeking medical attention (known as patient delay) and a two hour delay in presenting symptoms to a hospital (known as prehospital delay).

Results indicated that 64% of patients reported general awareness of the Warning Signs of Heart Attack campaign. A majority of these patients said that the campaign did increase their knowledge of what heart attacks are, improved their knowledge of the associated signs and symptoms, and influenced their actions after the onset of symptoms. The results also highlighted that awareness of the campaign was also linked to patient delay time of less than one hour and prehospital delay times of less than two hours.

The researchers conclude that there was generally high awareness of the campaign and it has been associated with reduced prehospital decisions and quicker presentation at hospitals.

You can read the full article here:

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