title: Chest pain in rural communities; balancing decisions and distance.
abstract: OBJECTIVE
  This pilot study examines the prevalence of cardiac risk factors in a cohort of agricultural workers, assesses their knowledge of local emergency health services and investigates their decision-making abilities with regard to when and how they would seek help when experiencing chest pain.
  
  
  METHODS
  Farm men and women were recruited from 20 rural Victorian sites and underwent health assessments for total cholesterol, blood glucose, weight, height and blood pressure. Participants completed a survey to determine their knowledge of chest pain treatment, local emergency services and likely response to chest pain.
  
  
  RESULTS
  Cardiac risk factors within this cohort of 186 adult farming men and women were common, with 61% of men (58/95, 95% confidence interval [CI] 51-70) and 74% of women (68/91, 95% CI 65-83) either overweight or obese. When asked to name their nearest ED, 10% of participants (19/184, 95% CI 7-16) nominated health services or towns where no ED exists. Furthermore, 67% of respondents (123/185, 95% CI 59-73) believed it was safe to travel to hospital by car while potentially having a myocardial infarction.
  
  
  CONCLUSIONS
  This cohort of agricultural workers were at considerable risk of experiencing acute coronary events, but many would make decisions about when and how to seek medical help for chest pain that are at odds with published community guidelines. These results highlight the need for education to improve knowledge of local emergency services and address behavioural barriers to accessing care.
authors.affiliation: Centre for Rural Emergency Medicine, Deakin University School of Medicine, Warrnambool, Victoria, Australia. tim.baker@deakin.edu.au
authors.forename: Tim
authors.initials: T
authors.lastname: Baker
authors.forename: Scott
authors.initials: S
authors.lastname: McCoombe
authors.forename: Cate
authors.initials: C
authors.lastname: Mercer-Grant
authors.forename: Susan
authors.initials: S
authors.lastname: Brumby
mesh_terms: D000328:Adult; D000383:Agriculture; D002637:Chest Pain / Q000453:epidemiology* / Q000628:therapy; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D014739:Victoria / Q000453:epidemiology