A protocol for the Heart Matters stepped wedge cluster randomised trial: The effectiveness of heart attack education in regions at highest-risk

Janet E. Bray; Ziad Nehme; Judith C. Finn; Jessica Kasza; Robyn A. Clark; Dion Stub; Dominique A. Cadilhac; Amanda K. Buttery; Janelle Woods; Joosup Kim; Ben J. Smith; Karen Smith; Susie Cartledge; Alison Beauchamp; Natasha Dodge; Tony Walker; Elizabeth Flemming-Judge; Clara Chow; Mary Stewart; Nicholas Cox; William van Gaal; Voltaire Nadurata; Peter Cameron

Resuscitation Plus (Sep 2023)

A protocol for the Heart Matters stepped wedge cluster randomised trial: The effectiveness of heart attack education in regions at highest-risk

Janet E. Bray,
Ziad Nehme,
Judith C. Finn,
Jessica Kasza,
Robyn A. Clark,
Dion Stub,
Dominique A. Cadilhac,
Amanda K. Buttery,
Janelle Woods,
Joosup Kim,
Ben J. Smith,
Karen Smith,
Susie Cartledge,
Alison Beauchamp,
Natasha Dodge,
Tony Walker,
Elizabeth Flemming-Judge,
Clara Chow,
Mary Stewart,
Nicholas Cox,
William van Gaal,
Voltaire Nadurata,
Peter Cameron

Affiliations

Janet E. Bray: Monash School of Public Health and Preventive Medicine, Monash University, Australia; School of Nursing, Curtin University, Australia; Alfred Health, Australia; Corresponding author at: Monash University, 553 St Kilda Rd -Level 3, Melbourne, VIC 3004, Australia.
Ziad Nehme: Monash School of Public Health and Preventive Medicine, Monash University, Australia; Ambulance Victoria, Australia
Judith C. Finn: Monash School of Public Health and Preventive Medicine, Monash University, Australia; School of Nursing, Curtin University, Australia
Jessica Kasza: Monash School of Public Health and Preventive Medicine, Monash University, Australia
Robyn A. Clark: Caring Futures Institute, Flinders University, Australia; Southern Adelaide Local Health Network, Australia
Dion Stub: Monash School of Public Health and Preventive Medicine, Monash University, Australia; Alfred Health, Australia; Ambulance Victoria, Australia
Dominique A. Cadilhac: Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Australia; Stroke Theme, Florey Institute of Neuroscience and Mental Health University of Melbourne, Australia
Amanda K. Buttery: National Heart Foundation of Australia, Australia
Janelle Woods: Monash School of Public Health and Preventive Medicine, Monash University, Australia; National Heart Foundation of Australia, Australia
Joosup Kim: Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Australia; Stroke Theme, Florey Institute of Neuroscience and Mental Health University of Melbourne, Australia
Ben J. Smith: Monash School of Public Health and Preventive Medicine, Monash University, Australia; Prevention Research Collaboration, School of Public Health, University of Sydney, Australia
Karen Smith: Monash School of Public Health and Preventive Medicine, Monash University, Australia; Department of Research and Innovation, Silverchain, Australia
Susie Cartledge: Monash School of Public Health and Preventive Medicine, Monash University, Australia
Alison Beauchamp: School of Rural Health, Monash University, Australia
Natasha Dodge: Monash School of Public Health and Preventive Medicine, Monash University, Australia
Tony Walker: Department of Paramedicine, Monash University, Australia
Elizabeth Flemming-Judge: Consumer Representative, Australia
Clara Chow: Faculty of Medicine and Health, Westmead Applied Research Centre, University of Sydney, Australia; Westmead Hospital, Australia
Mary Stewart: Victorian Department of Health, Australia
Nicholas Cox: Western Health, Australia
William van Gaal: Northern Health, Australia
Voltaire Nadurata: Bendigo Health, Australia
Peter Cameron: Monash School of Public Health and Preventive Medicine, Monash University, Australia; Alfred Health, Australia

Journal volume & issue: Vol. 15
p. 100431

Abstract

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Aim: To describe the Heart Matters (HM) trial which aims to evaluate the effectiveness of a community heart attack education intervention in high-risk areas in Victoria, Australia. These local government areas (LGAs) have high rates of acute coronary syndrome (ACS), out-of-hospital cardiac arrest (OHCA), cardiovascular risk factors, and low rates of emergency medical service (EMS) use for ACS. Methods: The trial follows a stepped-wedge cluster randomised design, with eight clusters (high-risk LGAs) randomly assigned to transition from control to intervention every four months. Two pairs of LGAs will transition simultaneously due to their proximity. The intervention consists of a heart attack education program delivered by trained HM Coordinators, with additional support from opportunistic media and a geo-targeted social media campaign. The primary outcome measure is the proportion of residents from the eight LGAs who present to emergency departments by EMS during an ACS event. Secondary outcomes include prehospital delay time, rates of OHCA and heart attack awareness. The primary and secondary outcomes will be analysed at the patient/participant level using mixed-effects logistic regression models. A detailed program evaluation is also being conducted. The trial was registered on August 9, 2021 (NCT04995900). Results: The intervention was implemented between February 2022 and March 2023, and outcome data will be collected from administrative databases, registries, and surveys. Primary trial data is expected to be locked for analysis by October 31st 2023, with a follow-up planned until March 31st 2024. Conclusion: The results from this trial will provide high-level evidence the effectiveness of a community education intervention targeting regions at highest-risk of ACS and low EMS use.

Published in Resuscitation Plus

ISSN: 2666-5204 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine
Website: https://www.journals.elsevier.com/resuscitation-plus

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