Beliefs and behavioral intentions regarding myocardial infarction among American Indians

Time to treatment following a myocardial infarction (MI) among Americans Indians in rural area is substantially higher compared to the U.S. general population. With assistance from tribal representatives, we designed a study to identify possible reasons for treatment delay, including knowledge of risk factors, signs and symptoms, and expected actions to be taken during an MI. Semi-structured interviews were conducted with individual American Indians living in Pine Ridge, Bemidji, and the Tucson rural areas—all of which have high rates of MI. We recruited 61 persons who had a previous MI and 130 persons who were at high risk for MI. Respondents were able to identify many of the risk factors for and consequences of MI, but very few identified diabetes or cholesterol as risk factors or heart damage as a consequence. They were receptive to receiving information about MI prevention and signs and symptoms, although MI respondents were less likely to know what information they need to prevent future MIs. Over 90 percent of all respondents expected heart-related symptoms to occur in an MI (chest pain, 97.4%), with smaller percentages expecting extra-cardiac symptoms to occur (e.g., neck pain, 59%; jaw pain, 49%). Forty-four percent of MI respondents reported waiting for more than one hour to call for help; 22% of non-MI respondents would wait for more than one hour to call for help.Findings indicate that education is needed with respect to the prevention of MI, symptoms, appropriate responses to MI, and the causes and consequences of an MI.