title: Emergency Department education improves patient knowledge of coronary artery disease risk factors but not the accuracy of their own risk perception.
abstract: BACKGROUND
  Coronary artery disease (CAD) is the single largest killer of both males and females in the United States. The Emergency Department (ED) represents a unique environment in which patient education may improve coronary artery disease risk factor knowledge and relative risk perception. ED patients' understanding of CAD risk factors is often limited. Patients' perception of their own risk is often not a reflection of their true risk. We hypothesized that an American Heart Association educational video intervention would improve patients' knowledge of coronary artery disease risk factors and personal risk awareness in the ED setting.
  
  
  METHODS
  IRB approval was obtained for this prospective observational cohort study. Our trial included 100 adult patients (age 18 and over), both male and female, using the ED population at an inner city tertiary care Level I trauma center hospital as our source of participants. Recruitment of patients began in January 2002 and ended in May 2004.
  
  
  RESULTS
  Patients who watched the educational video did improve their knowledge of cardiac risk factors significantly when compared to patients who received no educational video intervention. In our study, this information was not retained at 30-day follow-up. However, there was still significant improvement in their knowledge when compared to baseline scores pre-intervention. Patients overestimated their risk when compared to an objective measure of risk. In both the study and control groups, patients significantly overestimated their risk pre-educational intervention, immediately post-educational intervention, and at 30-day follow-up when compared to an objective measure of risk.
  
  
  CONCLUSIONS
  Simple educational intervention at a teachable moment (i.e. when a patient is experiencing chest pain in the ED) significantly improves patient's knowledge of CAD risk factors immediately post-intervention. This improvement in knowledge is not fully retained at 30-day follow-up, which suggests that patients may benefit from further educational intervention prior to 1 month follow-up. Patients overestimate their risk when compared to an objective measure of risk, regardless of whether they receive an educational intervention or not.
authors.affiliation: Wilford Hall Medical Center, 59th Medical Wing, Lackland AFB, TX 78236-9908, USA. annettelwilliams@gmail.com
authors.forename: Annette
authors.initials: A
authors.lastname: Williams
authors.forename: Christopher
authors.initials: C
authors.lastname: Lindsell
authors.forename: Laura
authors.initials: L
authors.lastname: Rue
authors.forename: Andra
authors.initials: A
authors.lastname: Blomkalns
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003327:Coronary Disease / Q000209:etiology*; D004521:Educational Measurement; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004638:Emergency Treatment; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007297:Inpatients / Q000193:education / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration*; D015397:Program Evaluation; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013664:Teaching Materials; D014193:Trauma Centers; D014743:Videotape Recording