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Health Care Providers’ Perspectives on Patient Delay for Seeking Care for Symptoms of Acute Myocardial Infarction

University of Massachusetts Medical Center, Preventive and Behavioral Medicine, Worcesterjzapka{at}banyan.ummed.edu

Barbara Estabrook, MSPH

University of Massachusetts Medical Center, Preventive and Behavioral Medicine, Worcester

Janice Gilliland, MSPH

School of Medicine at the University of Alabama at Birmingham

Laura Leviton, PhD

University of Alabama at Birmingham

Hendrika Meischke, PhD

King County Emergency Medical Services, Seattle, WA

Sharon Melville, MD, MPH

Bureau of HIV and STD at the Texas Department of Health, Austin

Judy Taylor, EdD

University of Alabama at Tuscaloosa

Mohamud Daya, MD

Department of Emergency Medicine at the Oregon Health Sciences University, Portland

Brian Laing, MS

Mayo Foundation for Medical Education and Research, Rochester, MN

Angela Meshack, DrPH

School of Public Health at the University of Texas Health Science Center, Houston

Roy Reyna, MD

Center for Health Promotion at the University of Texas at Austin

Mark Robbins, PhD

Cancer Prevention Research Center at the University of Rhode Island

Mary Hand, MSPH, RN

Office of Prevention, Education, and Control at the National Heart, Lung, and Blood Institute, Bethesda, MD

John Finnegan, PhD

Division of Epidemiology at the University of Minnesota, Minneapolis

To inform intervention development in a multisite randomized community trial, the Rapid Early Action for Coronary Treatment (REACT) project formative research was undertaken for the purpose of investigating the knowledge, beliefs, perceptions, and usual practice of health care professionals. A total of 24 key informant interviews of cardiologists and emergency physicians and 15 focus groups (91 participants) were conducted in five major geographic regions: Northeast, Northwest, Southeast, Southwest, and Midwest. Transcript analyses revealed that clinicians are somewhat unaware of the empirical evidence related to the problem of patient delay, are concerned about the practice constraints they face, and would benefit from concrete suggestions about how to improve patient education and encourage fast action. Findings provide guidance for selection of educational strategies and messages for health providers as well as patients and the public.

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