The primary aim of this study is to increase our understanding of care-seeking behavior surrounding acute coronary syndromes [ACS] through the application and testing of an integrated self-regulatory care-seeking model [ISCM] and the utilization of a world wide web [WWW] based ISCM survey instrument. Care-seeking delay among individuals stricken with ACS prevent many of them from obtaining the full therapeutic benefit of time dependent, hospital based thrombolytic and/or mechanical reperfusion therapy to reduce the morbid and mortal consequences of acute cardiovascular disease. Results from prior studies of ACS delay generally rely on measures of time duration extracted from emergency medical system logs and/or ED charts. By relying on such limited data sources, these studies have failed to take into consideration the complexity of the social contexts and behavioral processes by which individuals make decisions to seek medical care for ACS. The relative lack of success of public education interventions to decrease ACS delay results from a neglect of the social processes by which symptoms are evaluated, the way coping strategies are developed, and care-seeking influenced by lay others and social situations and circumstances. The Integrated Self-Regulatory Care-Seeking model makes it possible to delineate decision points, situations and circumstances critical to producing patterns of care-seeking that are efficient and expeditious or are protracted and delayed. The target sample size for this study is 2,314 individuals who have experienced an ACS episode. Subjects will be recruited to the study website by: extensive marketing of the study URL on [1] websites and in [2] discussion forums of interest to cardiac patients and individuals with known ACS risks; 3] emailing of a study flyer for posting in settings such as libraries, senior citizen centers, African-American churches, health clinics, and HMOs; 4] viral marketing of the study URL from peer to peer; and 5] using selected print media. The study utilizes a quota sampling techniques with quotas calculated from NHANES 1999-2000 and 2001- 2002 studies to obtain a representative sample of individuals with AMI and unstable angina crossed by age, gender and race. Statistical models will be used to estimate the effects of variables that characterize the decision process on time delay from acute symptom onset to ED arrival. ? ? ?
| Alonzo, Angelo A (2017) Studying Acute Coronary Syndrome Through the World Wide Web: Experiences and Lessons. JMIR Res Protoc 6:e182 |
