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REACT theory-based intervention to reduce treatment-seeking delay for acute myocardial infarction. Rapid Early Action
J M Raczynski1, J R Finnegan, J G Zapka
1Department of Medicine, Center for Health Promotion, University of Alabama at Birmingham, 35294, USA.
Insights
The REACT Trial developed a multi-component intervention to reduce patient delays in seeking care for acute myocardial infarction (AMI) symptoms. This intervention aims to improve eligibility for life-saving reperfusion therapies for coronary heart disease (CHD).
Area of Science:
- Cardiology
- Public Health
- Behavioral Science
Background:
- Coronary heart disease (CHD) is the leading cause of U.S. mortality.
- Timely treatment for acute myocardial infarction (AMI) is crucial for reducing morbidity and mortality.
- Patient delay in seeking care for AMI symptoms often makes them ineligible for critical reperfusion therapies.
Purpose of the Study:
- To describe the development and content of the theoretically-based REACT intervention.
- To test the effectiveness of a multi-component intervention in reducing patient delay for AMI symptom care-seeking.
- To inform future interventions aimed at improving timely access to AMI treatment.
Main Methods:
- A four-year, 20-community, randomized trial (REACT Trial).
- Development of a multi-component intervention informed by research literature and behavioral theories.
- Formative research to understand patient and provider perspectives on care-seeking barriers and facilitators.
- Focus on intervention design, core message content, target audiences, and intervention materials.
Main Results:
- The manuscript details the theoretical underpinnings and development process of the REACT intervention.
- It outlines the formative research, intervention components, and materials created.
- The study design includes outcome, impact, and process measurements linked to intervention theories.
Conclusions:
- The REACT intervention was developed to address critical delays in AMI care-seeking.
- The intervention's effectiveness will be evaluated through a randomized trial.
- Findings aim to improve patient outcomes for acute myocardial infarction by facilitating timely treatment.
Abstract:
Coronary heart disease (CHD) remains the leading cause of mortality in the U.S. Innovations in reperfusion therapies can potentially reduce CHD morbidity and mortality associated with acute myocardial infarction (AMI) when treatment is initiated within the first few hours of symptom onset. However, delay in seeking treatment for AMI is unacceptably lengthy, resulting in most patients being ineligible for reperfusion therapies. The Rapid Early Action for Coronary Treatment (REACT) Trial is a four-year, 20-community, randomized trial to design and test the effectiveness of a multi-component intervention to reduce patient delay for hospital care-seeking for AMI symptoms. This manuscript describes the development and content of the theoretically-based REACT intervention and summarizes: (1) the research literature used to inform the intervention; (2) the behavioral theories used to guide the development, implementation, and evaluation of the intervention; (3) the formative research undertaken to understand better decision-making processes as well as barriers and facilitators to seeking medical care as perceived by AMI patients, their families, and medical professionals; (4) the intervention design issues that were addressed; (5) the synthesis of data sources in developing the core message content; (6) the conceptualization for determining the intervention target audiences and associated intervention components and strategies, their integration with guiding theoretical approaches and implementation theories for the study, and a description of major intervention materials developed to implement the intervention; and (7) the focus of the outcome, impact, and process measurement based on the intervention components and theories on which they were developed.