Patient delay prior to seeking treatment for acute myocardial infarction (AMI) symptoms is the major factor limiting the ability to use reperfusion treatments to limit morbidity and mortality. African Americans are at particular risk for longer delays. Lack of knowledge is not the reason why patients delay, rather patients seem to have an image of AMI symptoms that is not consistent with their experience. The purpose of this pilot investigation is two-fold: The first purpose is to develop a computerized tailored educational program for African American men about the risk factors for cardiovascular disease (CVD), the symptoms associated with AMI, and the actions to take when experiencing the symptoms of AMI. The second purpose of this investigation is to examine the effectiveness of this computerized tailored educational program in improving African American men's knowledge and identification of AMI symptoms, risk factors and actions to take if symptoms are experienced compared to a usual care group. Data from this pilot study will be used to demonstrate feasibility support for the subsequent submission of a larger research project (R01) to test the effectiveness of a computerized tailored educational program on reducing patient delay in seeking treatment during AMI. Fifty African American men who have one or more cardiovascular risk factors or documented cardiovascular disease will be recruited from a Cardiology clinic located in an inner-city Medical Center. Subjects will be randomized to usual care or the experimental group. Subjects will complete a demographic questionnaire and a questionnaire about their knowledge of AMI symptoms. The usual care subjects will receive educational literature in addition to the standard information given by their provider. The experimental group will complete the tailored computerized educational program. At the completion of their clinic visit all subjects will again complete the questionnaire about their knowledge of AMI symptoms and will respond to the Symptom Simulation assessment. Subjects will be presented with 4 video scenarios depicting a range of symptom experiences. In each simulation the subject will be asked to indicate what they believe the problem is and rank order possible responses to the symptoms. Differences in knowledge about symptoms, risk factors, and responses to symptoms will be examined with chi-square tests for categorical responses and non-parametric rank tests for ordinal responses.
| Ryan, Catherine J; Choi, Heeseung; Fritschi, Cynthia et al. (2013) Challenges and solutions for using informatics in research. West J Nurs Res 35:722-41 |
