COMMUNITY HEART ACTION PROJECT

目的：患者越早经历急性心肌梗死 急性心肌梗死(AMI)接受再通治疗的患者预后越好。 遗憾的是，少数急性心肌梗死患者接受了再通治疗， 部分原因是抵达医院的延误。漫长的决策过程 急性心肌梗死患者对症状的不适当反应是 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对减少院前感染的效果 50岁及以上的人经历的延迟时间间隔 急性心肌梗塞的症状。 具体目标：1)评估两个项目的单独和联合效果 干预：(媒体运动和全社区干预)，以 减少急性心肌梗死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EMS使用的影响 服务和急诊科，关于使用再灌注疗法和 关于急性心肌梗死死亡率。 设计和方法：我们提出了一项随机对照干预试验 它针对所有有急性心肌梗死风险的个人(50岁的个人 或以上)。本研究将使用两种干预措施。媒体的干预将会 由公共教育、电视和广播活动组成。一个社区范围内的 被称为社区活动计划的干预措施将包括这两项 社区和人际干预。公共的组合， 患者和医疗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 (如老年人中心、教堂、俱乐部等)将会被使用。这个 拟议的研究确定了太平洋西北部四个可比的郊区 社区(两个在西雅图，两个在波特兰)和两个类似的农村 社区(L在西雅图，L在波特兰)。这个设计将使我们能够 衡量单独干预和联合干预的效果，并比较 把他们送到一个控制社区。

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.