Delay in seeking treatment for symptoms of atrial fibrillation (AF) results in a missed opportunity for early treatment that is critical to avert disbling complications of AF such as stroke, heart failure, and recurrent AF. Vital early treatment of AF in symptomatic patients could be improved if individuals sought evaluation at the onset of symptoms, but in our study, only 30% of patients with symptoms of AF sought evaluation within a week of symptom onset. Treatment-seeking for AF is hindered when people do not recognize symptoms that represent AF, attribute those symptoms to alternative causes, and do not believe symptoms are serious enough to require medical evaluation. Interventions tailored to modify patient-specific knowledge, attitudes, and beliefs that hinder early treatment-seeking are critically needed in order to improve early detection of AF. Although general information about symptoms of AF and their significance is available on professional websites, tailored cognitive behavioral interventions designed to target specific factors related to delay and instruments to evaluate the outcomes of those interventions are critically limited. The program of research proposed in this application will fill this gap. The purpose of this K23 Mentored Patient Oriented Research Career Development Award is to gain the knowledge and skills necessary to become an independently funded investigator developing interventions to improve and maintain the health of people at risk for and with AF. Toward that goal, this study will accomplish two aims: 1) test the psychometric properties of the Knowledge, Attitudes, and Beliefs about Atrial Fibrillation Survey (KABAFS) and 2) evaluate the feasibility of the Alert for Atrial Fibrillation program, a tailored cognitive behavioral intervention to promote knowledge, attitudes, beliefs, and behaviors that support early treatment-seeking for symptoms of AF in those at risk for development of AF. The longer term goal is to use the knowledge generated from this research to test the influence of the Alert for Atrial Fibrillation program on treatment-seeking delay in patients at risk for AF in a larger multisite clinical trial. Participants (N = 160) >age 65 will e recruited from a Midwest medical center and will be surveyed using the KABAFS to provide data for psychometric testing and tailoring the intervention;80 of those participants will be randomized to participate in the feasibility trial of the Alert for Atrial Fibrillation program. To achieve the aims of this study and meet the long term goal of promoting early treatment for AF, the training plan is designed to provide educational and training opportunities through coursework, seminars, conferences, and mentoring that will provide a valuable foundation from which to advance as an independent scientist. Through this training I will gain knowledge of psychometric testing principles and procedures that I will apply to testing the KABAFS and acquire knowledge and skills that will prepare me to conduct a larger clinical trial to evaluate th influence of the Alert for Atrial Fibrillation program on treatment-seeking delay in patients at rik for AF.

Public Health Relevance

Delay in treatment-seeking for symptoms of atrial fibrillation (AF) hinders early treatment that is critical for reducing disabling complications of stroke, heart failure, and recurrent AF. This research will provide critical, practical knowledge about the feasibility of conducting a randomized trial of the Alert for Atrial Fibrillation program, a tailord cognitive, behavioral intervention for reducing treatment-seeking delay for symptoms of AF. The knowledge gained from this research will be used to conduct a larger, well powered clinical trial to test the effect of the Alert for Atrial Fibrillation program on treatment-seeking delay for symptoms of AF.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23NR014253-02
Application #
8743306
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Huss, Karen
Project Start
2013-09-26
Project End
2016-07-31
Budget Start
2014-08-01
Budget End
2015-07-31
Support Year
2
Fiscal Year
2014
Total Cost
$138,053
Indirect Cost
$10,078
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905