Introduction: Prolonged delay by patients in making care-seeking decision remains the most significant limiting factor for effective management of acute myocardial infarction (AMI) despite decades of research.
Methods: This study adopted a mixed-method design, which included a pilot randomized controlled trial and an exploratory qualitative study. The study aimed to explore the feasibility of a modelling-based narrative intervention on care-seeking behavioral intention and prehospital care-seeking delays among AMI patients. We adopted an eclectic behavioral modelling-based intervention to optimize patients’ care-seeking behaviors by a narrative approach with story-telling to engage patients in a mental rehearsal for the decision-making process to care-seeking, through which to create a virtual but vivid learning experience. A total of 56 adult patients with a recent history of AMI were recruited from the cardiac clinic of a regional hospital in Hong Kong. These patients were randomly allocated to receive either the modelling-based narrative intervention or a didactic education.
Results: Patients in the intervention group reported higher care-seeking behavioral intention upon symptom occurrence, though the knowledge on AMI symptoms between the two groups was not significant. The acceptability of the modelling-based narrative intervention was high among the participants. They considered the intervention as interesting and informative. Over 90% of the participants in the intervention group expressed that they enjoyed the intervention and 82% attended all sessions.
Conclusions: This study is the first of its kind to adopt a behavioral modelling and narrative approach to optimize care-seeking behaviors among patients with AMI. The preliminary findings showed that this approach was well received by patients. Longer term effects in reducing prehospital delay is yet to be determined.