title: Factors influencing delay in seeking treatment for acute ischemic symptoms among lower income, urban women.
abstract: OBJECTIVE
  We examined factors associated with delay in seeking emergency medical attention for acute ischemic symptoms in a sample of predominantly African American women.
  
  
  METHODS
  Female patients who presented with symptoms of acute myocardial infarction (AMI) were interviewed. Qualitative and quantitative methods were used to examine barriers associated with delay.
  
  
  RESULTS
  The mean hours of delay were 20.4 (median = 4.5 hours). Sixty-nine percent of the patients delayed 1 hour or more. These delays were associated with younger age, African American ethnicity, poorer self-rated health, and the belief that one could not personally ever have an AMI. In a multiple logistic regression model, the belief that one could not ever have an AMI significantly increased the odds of delay compared with other patient characteristics.
  
  
  CONCLUSIONS
  The results indicate that efforts should be made to increase women's awareness of personal risk for AMI and the need for development of cognitive representations of AMI.
authors.affiliation: Center for Urban Health Policy and Research, Philadelphia, PA 19144, USA.
authors.forename: Tina L
authors.initials: TL
authors.lastname: Harralson
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D003863:Depression / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000208:ethnology; D017202:Myocardial Ischemia / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D010465:Perception; D011203:Poverty; D011584:Psychology; D012720:Severity of Illness Index; D012944:Social Support; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D044465:White People