Heart Attack Education and EMS Response in High-Risk, Low EMS Usage Areas

Does community-based heart attack education in regions with high cardiovascular risk and low emergency medical services (EMS) use improve patients’ response to acute coronary syndrome (ACS)?In this stepped-wedge, cluster-randomized trial including 1775 patients with ACS, there was a 9% reduction in EMS use during the intervention. Coordinators reported that the COVID-19 pandemic and seasonal weather effects reduced event attendance, and that the community raised concerns about costs, emergency demand, and wait times.These findings suggest that community education interventions are complex and can be influenced by external factors that may negate the intervention’s impact.

Corresponding Author: Janet E. Bray, PhD, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia (janet.bray@monash.edu).

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