Key result
An e-learning program improves AMI symptom knowledge and self-regulation but not EMS call intention.
Why the study?
Delayed contact with emergency medical services contributes to poor outcomes following AMI, particularly among older adults with limited symptom recognition, motivating evaluation of an e-learning program on AMI-related knowledge, health beliefs, and decision-making.
Does a two-week e-learning program improve AMI-related knowledge, health beliefs, and decision-making in older adults in urban communities in Thailand?
Does a two-week e-learning program improve AMI-related knowledge, health beliefs, and decision-making in older adults in urban communities in Thailand?
An e-learning program based on the Health Belief Model can effectively improve AMI symptom recognition and risk factor knowledge among older urban adults, though larger randomized trials are needed to confirm effects on emergency decision-making.
May improve AMI knowledge in older Thai adults; leaves open whether it shortens EMS delays in controlled trials.
Background: Delayed contact with emergency medical services (EMS; 1669 in Thailand) contributes to poor outcomes following acute myocardial infarction (AMI), particularly among older adults with limited symptom recognition. This study evaluated the effects of an e-learning program on AMI-related knowledge, health beliefs, and decision-making among older adults in urban Thailand. Methods: A one-group pretest–posttest design with follow-up was conducted from December 2025 to January 2026. Thirty-five older adults aged 60–85 years from urban communities in Bangkok and nearby provinces participated. The two-week e-learning intervention comprised four interactive lessons based on the Health Belief Model and American Heart Association recommendations. AMI knowledge, health beliefs, and decision-making were assessed at pretest, posttest, and follow-up using repeated-measures analyses. Results: Knowledge of coronary artery disease risk factors (p < 0.05; η²ₚ = 0.213) and AMI symptoms (p < 0.001; η²ₚ = 0.357) increased significantly over time. Perceived self-regulation (p < 0.001; η²ₚ = 0.302) and cues to action (p < 0.05; η²ₚ = 0.110) also improved significantly. Perceived severity improved post-intervention but declined at follow-up. No significant changes occurred in perceived susceptibility, benefits, or barriers scores. Decision-making differed significantly across time, although no significant improvement was observed from baseline to either post-intervention or follow-up. The proportion intending to call EMS when encountering someone with an AMI increased from 68.6% at baseline to 88.6% immediately after intervention was completed, but this change was not statistically significant. Conclusion: The e-learning program improved AMI-related knowledge and selected health beliefs, but effects on decision-making were inconclusive. Future studies should use a randomized controlled trial with a larger and stronger scenario-based measures.
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Madsong et al. (2026) studied Suspected Acute Myocardial Infarction (n=35). E-learning program on AMI-related knowledge, health beliefs, and decision-making vs. Baseline (pretest) was evaluated on AMI knowledge, health beliefs, and decision-making (including proportion intending to call EMS) (η²ₚ = 0.357 (for AMI symptom knowledge), p=<0.001). A two-week e-learning program significantly improved AMI symptom knowledge (p<0.001; η²ₚ=0.357) and self-regulation (p<0.001; η²ₚ=0.302), though EMS call intention (68.6% to 88.6%) was not significant.
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