Improving time to treatment following heart attack for rural American Indian and Alaska Natives

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.