COMMUNITY HEART ACTION PROJECT

目的：患者越早发生急性心肌梗死， 急性心肌梗死（AMI）接受再灌注治疗的结果越好。 遗憾的是，少数AMI患者接受再灌注治疗， 部分原因是到达医院的时间延迟。冗长的决策 和对AMI患者症状的不适当反应， 院前延迟间隔的关键。这项提案将考验 以社区为基础的干预措施的有效性， 50岁及以上经历过 急性心肌梗死的症状 具体目标：1）评估两个人的单独和联合有效性 干预措施：（媒体宣传和全社区干预）， 减少AMI症状的院前延迟间隔。2)评估 农村和城市/郊区干预措施的有效性 社区3)确定干预措施对环管系统使用的影响 服务和急诊科，使用再灌注治疗， 急性心肌梗死死亡率。 设计和方法：我们提出一个随机对照干预试验 其针对所有有AMI风险的个体（50岁以下的个体 本研究将采用两种干预措施。媒体的介入将 包括一个公共教育电视和广播运动。全港推行 一项名为“社群活动计划”的干预措施将包括 社区和人际干预。一个公共的组合， 患者和卫生保健提供者的教育干预，以及 与目标群体有联系的社区团体的参与 (such如老年人中心、教堂、俱乐部等）将用于的 拟议的研究确定了四个可比的郊区，太平洋西北部 社区（2个在西雅图和2个在波特兰）和两个可比较的农村 社区（l在西雅图，l在波特兰）。这个设计可以让我们 衡量单独和联合干预措施的效果，并比较 一个控制社区。

Objectives: The sooner a patient experiencing an acute myocardial infarction (AMI) receives reperfusion therapy the better the outcome. Regrettably, a minority of patients with AMI receive reperfusion therapy, in part due to delays in arriving at the hospital. Lengthy decision making and inappropriate responses to symptoms on the part of the AMI patient are key to prehospital delay intervals. This proposal will test the effectiveness of community-based interventions to decrease prehospital delay intervals among individuals 50 years of age and over who experience symptoms of acute myocardial infarction. Specific Aims: 1) Evaluate the individual and joint effectiveness of two interventions: (a media-campaign and a community-wide intervention), to decrease prehospital delay intervals for symptoms of AMI. 2) Assess the effectiveness of the interventions in a rural and an urban/suburban community. 3) Determine the impact of the interventions on the use of EMS services and emergency departments, on the use of reperfusion therapy and on AMI mortality. Design and Methods: We propose a randomized controlled intervention trial which targets all individuals at risk of AMI (individuals 50 years of age or over).This study will use two interventions. A media intervention will consist of a public education TV and radio campaign. A community-wide intervention, called the Community Activities Plan, will include both community and interpersonal interventions. A combination of public, patient and health care provider education intervention as well as involvement of community groups that have contact with the target group (such as senior citizen centers, churches, clubs, etc.) will be used. The proposed study identifies four comparable suburban, Pacific Northwest communities (2 in Seattle and 2 in Portland) and two comparable rural communities (l in Seattle, l in Portland). The design will allow us to measure the effects of the separate and combined interventions and compare them to a control community.