The aim of the study is to evaluate whether providing a targeted heart health education campaign to regions at high risk of heart attacks will improve ACS patient's symptom recognition and response. The intervention will be will be evaluated according to a cluster randomized, stepped wedged design. The clusters are eight local government areas (LGAs) in Victoria, Australia. The main primary outcome will be assessed in consecutive patients presenting to emergency departments from the six LGAs throughout the study period with an ED diagnoses of acute coronary syndrome.
Primary objectives: To determine if targeted heart health education will: 1. Increase ambulance use in ACS patients (main primary outcome); 2. Decrease patient and prehospital delay times in ACS patients; 3. Increase awareness of personal cardiovascular risk and associated factors in adult community members; and 4. Increase cardiovascular knowledge and confidence to act to heart attack warning signs in adult community members. Secondary objectives 1. To determine if targeted heart health education: 2. Reduces the incidence of out-of-hospital cardiac arrest; 3. Improves survival in OHCA patients; 4. Improves survival in ACS patients; 5. Improves survival and ACS patients; 6. Increases presentations to ED for ACS and unspecified chest pain; and 7. Increases the rates of calls to ambulance for chest pain and non-chest pain. 8. Increases the rate of Heart Health Checks. Intervention: To meet the objectives of the study, we will employ HM coordinators for each of the eight high-risk LGAs to organise and deliver our HM education program using HM materials and Partner resources. Design: The stepped-wedge design is a uni-directional cross-over design - where the randomisation element is when the cluster crosses-over to the intervention following a control period. Over the 16-month study period, the eight LGAs will move into the intervention phase at two month intervals. As four LGAs are in close proximity, these LGAs will switch from control to intervention periods at the same time to avoid possible contamination.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
2,240
Heart Matters coordinators will deliver heart health education to the community using HM materials and Partner resources.
Victorian LGAs
Melbourne, Please Select, Australia
Ambulance use for ACS
The proportion of ACS patients that present to ED by ambulance.
Time frame: 16 months
Median ACS patient delay time
The median ACS patients delay time (time from symptom onset to decision to seek medical attention).
Time frame: 16 months
ACS patient delay time <60 minutes
The proportion of ACS patients with patient delay times \<60 minutes
Time frame: 16 months
Median ACS patient prehospital delay time
The median ACS patient prehospital delay time (time from symptom onset to arrival at hospital).
Time frame: 16 months
ACS patients prehospital delay times <120 minutes
The proportion of ACS patients with prehospital delay times \<120 minutes
Time frame: 16 months
Awareness of own risk of heart attack
The proportion of adult members of the community who are aware of their own risk of heart attack.
Time frame: 0-2 months and 6-8 months
Awareness of heart attack as a leading cause of death
The proportion of adult members of the community who identify heart disease a leading cause of death
Time frame: 0-2 months and 6-8 months
Awareness of heart attack risk factors
The proportion of adult members of the community who identify cardiovascular risk factors
Time frame: 0-2 months and 6-8 months
Number of correctly named heart attack risk factors
The number of correctly named cardiovascular risk factors by adult members of the community
Time frame: 0-2 months and 6-8 months
Awareness of heart attack signs and symptoms
The proportion of adult members of the community aware of heart attack symptoms
Time frame: 0-2 months and 6-8 months
Number of correctly named heart attack signs and symptoms
The number of correctly named ACS symptoms by adult members of the community
Time frame: 0-2 months and 6-8 months
Confidence in knowing how to act
The proportion adult members of the community who are confident about what they would do if experiencing a heart attack
Time frame: 0-2 months and 6-8 months
Ambulance use in scenarios
The proportion adult members of the community who correctly state they would call an ambulance for two heart attack scenarios.
Time frame: 0-2 months and 6-8 months
Rates of Heart Health Checks
Rates of Medicare claims for General Practitioner (GP) Heart Health Checks
Time frame: 16 months
Rates of ACS ED presentations
The rates of ED presentations that are ACS
Time frame: 16 months
Rates of unspecified chest pain ED presentations
Rates of ED presentations that are unspecified chest pain
Time frame: 16 months
ACS ED presentations via GPs
Proportion of ACS ED presentations via General Practitioners
Time frame: 16 months
Rates of ACS survival
The proportion of ACS patients surviving to hospital discharge
Time frame: 16 months
Incidence of OHCA
incidence of out-of-hospital cardiac arrest
Time frame: 16 months
Rates of OHCA
Rates out-of-hospital cardiac arrest survival
Time frame: 16 months
Calls to ambulance for chest pain
Proportion of chest pain (event type 10) calls to ambulance
Time frame: 16 months
Calls to ambulance for non- chest pain
Proportion of non-chest pain emergency calls to ambulance
Time frame: 16 months
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