754 The Heart Matters Partnership: A Stepped-Wedge, Cluster-Randomised Trial Targeting Victorian Regions at High-Risk of Heart Attacks With Heart Health Education

Abstract

The National Heart Foundation’s (NHF) Victorian Heart Maps allow for the identification of Local Government Areas (LGAs) at highest-risk of heart attacks. These regions also have higher rates of risk factors, lower cardiovascular knowledge and lower ambulance use for acute coronary syndrome (ACS) events. The Heart Matters Partnership (between Monash University, NHF, Ambulance Victoria and the Victorian Government) aims to improve public awareness of the personal risk of ACS, ACS symptoms, and the importance of calling an ambulance. To do this we will implement local campaigns in 8 high-risk LGAs, including embedding education coordinators to organise and provide tailored community education. Primary outcomes are: 1) the proportion of ACS presentations by ambulance (main outcome); 2) prehospital delay times: 3) ACS knowledge; 4) rates of Heart Health Checks. Secondary outcomes include: cardiac arrest survival and incidence; ambulance calls and ED presentations for chest pain; and infarct size. The trial is due to commence in October 2020 and will run for 16-months. Eight LGAs were selected based on achieving an adequate sample of ACS patients (n=2240) to detect a change in the proportion arriving by ambulance from 61% to 72% using a stepped-wedge cluster-randomised design –in which LGAs move from control to intervention at 2-month periods. This study will determine whether providing community education to communities at highest-risk can change ACS recognition and response and improve ACS outcomes. Such evidence is also important to practice and policy makers across Australia and internationally.