COMMUNITY INTERVENTION TO REDUCE MI DELAY

拟议的为期四年的随机、受控、多中心干预 研究旨在减少与识别和识别相关的延迟时间 对急性心肌梗死(AMI)症状的反应。在这 申请实地选址，我们建议分两期进行研究 城市对：1)德克萨斯州的拉雷多和德克萨斯州的布朗斯维尔；2)泰勒， 德克萨斯州和路易斯安那州的查尔斯湖。数据收集将包括1) 四个城市基线和跟踪抽样调查的电话调查 评估有关急性心肌梗死的知识、态度和行为意图 症状识别和反应；2)中期干预电话调查 两个干预城市(每对各一个)以评估对艾滋病的认识 干预渠道、材料和态度的选择 AM症状识别和反应；3)住院患者访谈 正在对急性心肌梗死症状进行评估，包括症状出现、识别和 回答；以及4)受访参与者的病历摘要 关于最终诊断、病史、医院病程(例如， 治疗和并发症)和出院时的生命状况。 为期两年的多渠道干预计划将包括两个“小”项目 (如小册子)和“大型”(如电视新闻)媒体 组件。数据分析将包括检查 对1)延误时间、2)急救医疗利用的干预 服务部门和急诊科，3)溶栓治疗的使用 和即刻血管成形术治疗急性心肌梗死，4)住院病例- 致命性，以及5)关于以下方面的知识、态度和行为意图 急性心肌梗死症状识别和反应。如果成功，这种干预 该计划应成为在全美传播的典范 减少急性心肌梗死延迟时间。

The proposed four-year, randomized, controlled, multicenter intervention study is designed to reduce delay time associated with recognition and response to symptoms of acute myocardial infarction (AMI). In this application for a Field Site, we propose to carry out the study in two pairs of cities: 1) Laredo, Texas and Brownsville, Texas; and 2) Tyler, Texas and Lake Charles, Louisiana. Data collection will include 1) telephone surveys of samples of the four cities at baseline and follow-up to assess knowledge, attitudes, and behavioral intentions regarding AMI symptom recognition and response; 2) mid-intervention telephone surveys in the two intervention cities (one from each pair) to assess awareness of the intervention channels and materials and selected attitudes regarding AM symptom recognition and response; 3) in-hospital interviews of patients being evaluated for AMI symptoms regarding symptom onset, recognition, and response; and 4) medical record abstraction for interviewed participants regarding final diagnosis, medical history, hospital course (eg., treatments and complications) and vital status at the time of discharge. The two-year multichannel intervention program will include both "small" (eg., brochures) and "large" (eg., television news pieces) media components. Data analysis will include examination of the effect of the intervention on 1) delay time, 2) utilization of emergency medical services and emergency departments, 3) utilization of thrombolytic therapy and immediate angioplasty as therapy for AMI, 4) in-hospital case- fatality, and 5) knowledge, attitudes, and behavioral intentions regarding AMI symptom recognition and response. If successful, this intervention program should serve as a model for dissemination across the U.S. to reduce AMI delay time.