Lay referral patterns involved in cardiac treatment decision making among middle-aged and older adults

Nancy E. Schoenberg, Cheryl H. Amey, Eleanor Palo Stoller, Susan B. Muldoon

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Purpose: This study examined age and contextually related factors that are influential in lay referral patterns during cardiac treatment decision making. Design and Methods: A complementary design was used. The Myocardial Infarction (MI) Onset Study identified demographic correlates of who sought medical care for 1,388 MI (heart attack) survivors. Thirty-five in-depth MI illness narratives explicated lay referral patterns. Results: Data revealed a linear association between older age and reliance on another person to seek medical attention for cardiac symptoms, with gender also shaping lay referral patterns. Although spouses and children were the most frequently cited decision makers for older respondents, friends and other family members also influenced care-seeking decisions. Qualitative results substantiated and provided explanations for such patterns. Implications: Our results highlight the need for researchers to attend to the complex social processes of lay consultation and for health education messages to extend to venues where lay cardiac decisions are made, including the worksite and social gathering places such as religious institutions. Enhanced outreach includes tailoring health messages to elders and their significant others and casting a broader net to include nontraditional significant others.

Original languageEnglish
Pages (from-to)493-502
Number of pages10
Issue number4
StatePublished - Aug 2003

Bibliographical note

Funding Information:
This research was supported by Scientist Development Grant 0030022N awarded to Dr. Nancy Schoenberg by the American Heart Association. We also acknowledge assistance from Mia Rosenfeld, Elaine Drew, Z. J. Zheng, James Muller, Murray Mittleman, and hundreds of myocardial infarction (MI) survivors willing to engage in interviews.


  • Coronary heart disease
  • Gender
  • Lay referral
  • Treatment decision making

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology


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