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Abstract #147401

J. Nell Brownstein, PhD¹, Mark A. Veazie, DrPH², Eric A. Brody, MD, FACC², James M. Galloway, MD FACCP, FACC², Ellen Sommer, MBA³, Theresa C. Long³, Erin McDonald Bicknell⁴, Crystelle Fogle⁵, Carol White⁶, Marcia O'Leary, RN⁷, Sue Sherwood⁷, Carla Rae Marshall⁸, Arlene Marshall⁹, Clark H. Denny, PhD¹, and Lazette Lawton¹. (1) Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Bufford Hwy, N/E MS k-47, Atlanta, GA 30341-3717, 770 488-2570, jnb1@cdc.gov, (2) Native American Cardiology Program, Indian Health Service, 1215 N Beaver St Suite 201, Flagstaff, AZ 86001, (3) National Heart, Lung, and Blood Institute, Office of Prevention, Education, and Control, Bld. 31, Suite 4A20 MSC 2480, Bethesda, MD 20892-2480, (4) State Health Alliances, American Heart Association, 2201 San Pedro NE, Building 2, Suite 102, Albuquerque, NM 87110, (5) Montana Cardiovascular Health Program, Montana Dept. of Public Health & Human Services, PO Box 202951, Helena, MT 59620-2951, (6) Alaska Division of Public Health, Heart Disease and Stroke Prevention Program, PO Box 110616, Juneau, AK 99811-0616, (7) Missouri Breaks Indian Research Inc., HCR 64, Box 52, Timber Lake, SD 57656, (8) Cheyenne River Sioux Tribe, Media Department, 121 E. St. Francis Street, Rapid City, SD 57701, (9) Cheyenne River Sioux Tribe, Health Education Department, 1130 Mt. Rushmore Rd, Rapid City, ND 57701

Every year, more than 1 million Americans have a first or recurrent heart attack/myocardial infarction (MI) and about one-third of these will be fatal. Early recognition of MI by both the victim and bystanders, followed by prompt cardiac emergency care, has a direct effect on patient outcomes.

Data from the National MI Registry show that American Indians/Alaska Natives (AI/AN) experience the greatest disparity in time to treatment. Data from the Native American Cardiology Program show that rural American Indians presenting with acute MI have significant delays in time to treatment compared with the national average, thus severely limiting their treatment options.

We sought to gain an understanding of the barriers related to these delays by obtaining information through independent, semi-structured telephone interviews with key informants (tribal health care providers and community leaders) and community focus groups. Participants represent three U.S. regions: the Great Plains, the Southwest, and Alaska. Information obtained from participants includes their beliefs, perceptions, and behaviors affecting these delays. To address the barriers that contribute to treatment delays, culturally tailored and clear communications messages, identified messengers, and methods of delivery that have the potential to reduce time to treatment will be shared.

This project was developed as an initiative of the Healthy People 2010 Heart Disease and Stroke Partnership, a consortium of multiple federal agencies and the American Heart Association. Planning, implementation, and evaluation of the project are being guided by an advisory group made up of tribal and state representatives and members of the Partnership.

Learning Objectives:

• Summarize the current disparities in time to treament following a heart attack in rural AI/AN populations.
• Describe at least two critical barriers that keep American Indians and Alaskan Natives (AI/AN)from seeing immediate medical attention while having a heart attack.
• Identify the perfered styles of communication of messages by rural AI/NA populations.
• Identify two methods of delivering messages that prompt urgent action to the rural AI/AN populations.

Keywords: Myocardial Infarction,

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.