title: Mass media interventions to reduce help-seeking delay in people with symptoms of acute myocardial infarction: time for a new approach?
abstract: Minimizing patient delay in seeking care for acute myocardial infarction (AMI) is important in the reduction of morbidity and mortality. However, mass media interventions to reduce these delays have had limited success. This paper critiques delay reducing intervention studies and draws on other public health campaigns to identify new directions. A Medline search for the years 1985 through 2000 yielded eight intervention studies meeting inclusion criteria. Three of eight studies reported successful interventions although two of three were only marginally successful. Most studies used similar messages. Campaign lengths, type of media, and sample sizes varied. High risk populations and those with confirmed MI responded more quickly. To reduce patient delay, media messages need to do more than create awareness. Future interventions should target high risk audiences, promote dialogue between previous AMI patients and high risk patients, address problems of denial, provide gender specific education, and emphasize symptom evaluation, problem solving, and decision-making skills.
authors.affiliation: University of California San Francisco, 2 Kirkham, Box 0610, San Francisco, CA, USA. mcaldwe@itsa.ucsf.edu
authors.forename: Mary A
authors.initials: MA
authors.lastname: Caldwell
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
mesh_terms: D000208:Acute Disease; D006266:Health Education; D006801:Humans; D008402:Mass Media / Q000706:statistics & numerical data; D009203:Myocardial Infarction; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010565:Persuasive Communication; D013997:Time Factors; D014481:United States