Donna R. Zwas
Redressing the Red Dress
Hadassah Medical Center
homecirculationvol 137 8redressing red dress free accessarticle commentarypdfepubaboutview pdfview epubsections toolsadd favoritesdownload citationstrack citationspermissions shareshare onfacebooktwitterlinked inmendeleyreddit jump tofree accessarticle commentarypdfepubredressing red dressrethinking campaign donna r zwas md mph donna r zwasdonna r zwas linda joy pollin cardiovascular wellness center women heart institute hadassah university medical center jerusalem israel originally published20 feb 2018httpsdoiorg101161circulationaha117031574circulation 2018137763765since 2002 female cardiovascular mortality significantly decreased according centers disease control prevention wonder search database 491 713 american women died cardiovascular disease 2002 compared 399 028 2014 improvement attributed part joint efforts national heart lung blood institute heart truth campaign american heart association go red women campaign womenheart campaign national coalition women heart disease womens heart alliance along many partners joined efforts increase awareness heart disease women epidemiological findings challenge tease factors led improvements cardiovascular outcomes women understanding worked guide development implementation future campaigns aimed reducing cardiovascular mortalitywhat workeddata surveys suggest awareness heart disease significantly increased larger increases whites latinos blacks1 women likely aware heart disease number 1 killer women yet percentages remain suboptimal 55 although go red red dress campaigns targeted women 40 60 years age increased awareness healthcare providers due campaign may critical factor decreased mortality seen women recent survey primary care physicians cardiologists found 82 cardiologists felt well prepared extremely well prepared 5 primary care providers felt inadequately prepared assess cardiovascular risk women2 90 cardiologists primary care providers agreed women present different signs symptoms heart disease men increased awareness part physicians nurses healthcare providers leads increased recognition heart disease women myocardial infarction women seek medical advice likely referred timely intervention healthcare provider awareness likely led significant narrowing gender disparities hospitalbased care although sex differences myocardial infarction treatment remain statistically clinically significant many studies shown sex differences doortoballoon time narrowed women almost likely men undergo percutaneous surgical intervention acute coronary syndrome setting timely appropriate care ambulatory hospital settings may account much decrease mortality implementation checklists overcome implicit biases may serve augment adherence guidelines inclusion gender analysis within performance measureswhat hasnt happeneddespite focus signs symptoms heart disease women clear call action call ambulance significant gender disparity remains time first symptoms arrival emergency department3 delays seeking help associated increased inhospital 30day mortality likely contribute excess mortality women myocardial infarctionhow get women seek help earliercampaigns reduce delays seeking help acute myocardial infarction mostly unsuccessful4 although education awareness heart disease first steps identification variables impact decision seek care potential guide campaign lead reduction time treatment qualitative studies suggested even patient knows experiencing chest pain chest pain associated myocardial infarction denial severity urgency gravity symptoms lead delay seeking care5 attempts ameliorate symptoms pain relievers associated extended waiting periods gender concerns include requirements caregiving fear perceived hysterical fear dismissed medical staff feelings vulnerability fears loss autonomy control hospital environment signs symptoms infarction may attributed anxiety anxiety may obstruct immediate action lower socioeconomic strata fear expense ambulance medical care frequently cited major concern leading delayit challenging identify factors lead woman seek help quickly currently qualitative data suggest intensity discomfort main trigger actionable factors need identified used future campaigns advice encouragement others may also play rolenext steps campaignresearch specifically decision threshold identifying factors obstruct motivate helpseeking behavior incorporated messaging narrative campaignfocus barriers promoters campaign specifically address denial mechanisms fears genderspecific concerns well positive triggers educating family members may also increase likelihood timely evaluationtarget vulnerable populations women minorities poorly educated low socioeconomic strata elderly consistently found significant delays presentation messages need tailored low health literacy targeted specific ethnic communities lowincome individuals caregivers elderly also target groupsimplify message long list potential signs symptoms confusing ultimately may decrease likelihood seeking help atypical symptoms given almost equal weight many may experienced daily weekly basis woman unlikely seek help even chest pain education programs find women underrecognize symptoms program frequently overrecognize unrelated symptoms afterward almost anything everything heart attack longer clear trigger action women without cardiac disease commonly suffer pain including shoulder pain back pain campaign focus chest pain shortness breath intensity symptomsstreamline message fear campaigns require single concrete action item overwhelm paralyze recipient merging messages regarding prevention detracts essential action item calling ambulance prevention symptom campaigns separatedbeyond media social advocacy public policy core factors activity campaigns continue advocate items specifically address barriers insurance coverage ambulances emergency room visits seek care appropriate circumstances required part healthcare reform call lines outofthebox interventions may help equivocate enable overcome denial anxietyconclusionssocial marketing campaigns likely played integral role reducing cardiovascular mortality women burgeoning social media provides platform effective messaging preventive interventions shifting focus overcoming barriers clarifying threshold seeking help womens heart health campaign continue reduce disparities save livesdisclosuresnonefootnotesthe opinions expressed article necessarily editors american heart associationhttpcircahajournalsorgdonna r zwas md mph linda joy pollin cardiovascular wellness center women heart institute hadassah university medical center po box 12000 jerusalem israel il 9112011 email email protectedreferences1 mosca l hammond g mocharigreenberger h towfighi albert mafifteenyear trends awareness heart disease women results 2012 american heart association national surveycirculation 2013 12712541263linkgoogle scholar2 bairey merz cn andersen h sprague e burns keida walsh mn greenberger p campbell pollin mccullough c brown n jenkins redberg r johnson p robinson bknowledge attitudes beliefs regarding cardiovascular disease women womens heart alliancej coll cardiol 2017 70123132 doi 101016jjacc201705024crossrefmedlinegoogle scholar3 nguyen h saczynski j gore j goldberg rage sex differences duration prehospital delay patients acute myocardial infarction systematic reviewcirc cardiovasc qual outcomes 2010120 doi 101161circoutcomes110957878google scholar4 kainth hewitt sowden duffy pattenden j lewin r watt thompson dsystematic review interventions reduce delay patients suspected heart attackemerg med j 2004 21506508crossrefmedlinegoogle scholar5 nymark c saboonchi f mattiasson ac henriksson p kiessling adevelopment validation instrument assess patients appraisal emotions action tendencies preceding careseeking acute myocardial infarction paami questionnaireeur j cardiovasc nurs 2016 16240248 doi 1011771474515116652758crossrefmedlinegoogle scholar previous back top next figuresreferencesrelateddetailscited echols bond r ferdinand k 2022 social determinants cardiovascular health cardiovascular risk assessment primary prevention 101007978303098824119 391411 mackay 2019 sex disparities acute coronary syndrome care time move understanding action heart 101136heartjnl2019315887 1062 9293 online publication date 1jan2020 february 20 2018vol 137 issue 8 advertisement article informationmetrics 2018 american heart association inchttpsdoiorg101161circulationaha117031574pmid 29459459 originally publishedfebruary 20 2018 keywordscardiovascular diseasessocial marketingawarenesshealth care seeking behaviorwomenpdf download advertisement subjectscardiovascular diseaseethics policyhealth serviceswomen sex gender