• Ziad Nehme, Peter Cameron, Emily Nehme, Judith Finn, Emma Bosley, Deon Brink, Stephen Ball, Tan N Doan, and Janet E Bray.
• School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Centre for Research and Evaluation,Ambulance Victoria, Blackburn North, Victoria, Australia; Department of Paramedicine, Monash University, Frankston, Victoria, Australia. Electronic address: ziad.nehme@ambulance.vic.gov.au.
• Resuscitation. 2023 Oct 1; 191: 109932109932.

AimAwareness of heart attack symptoms may enhance health-seeking behaviour and prevent premature deaths from out-of-hospital cardiac arrest (OHCA). We sought to investigate the impact of a national awareness campaign on emergency medical service (EMS) attendances for chest pain and OHCA.MethodsBetween January 2005 and December 2017, we included registry data for 97,860 EMS-attended OHCA cases from 3 Australian regions and dispatch data for 1,631,217 EMS attendances for chest pain across 5 Australian regions. Regions were exposed to between 11 and 28 months of television, radio, and print media activity. Multivariable negative binomial models were used to explore the effect of campaign activity on the monthly incidence of EMS attendances for chest pain and OHCA.ResultsMonths with campaign activity were associated with an 8.8% (IRR 1.09, 95% CI: 1.07, 1.11) increase in the incidence of EMS attendances for chest pain and a 5.6% (IRR 0.94, 95% CI: 0.92, 0.97) reduction in OHCA attendances. Larger intervention effects were associated with increasing months of campaign activity, increasing monthly media spending and media exposure in 2013. In stratified analyses of OHCA cases, the largest reduction in incidence during campaign months was observed for unwitnessed arrests (IRR 0.93, 95% CI: 0.90, 0.96), initial non-shockable arrests (IRR 0.93, 95% CI: 0.90, 0.97) and arrests occurring in private residences (IRR 0.95, 95% CI: 0.91, 0.98).ConclusionA national awareness campaign targeting knowledge of heart attack symptoms was associated with an increase in EMS use for chest pain and a reduction in OHCA incidence and may serve as an effective primary prevention strategy for OHCA.Copyright © 2023 Elsevier B.V. All rights reserved.

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