For example: Were the questions clear? Did the wording make sense? Were they confused by anything? What did they think the questionnaire was trying to get selleck compound at? They will also be asked if they think anything should be covered on the instrument that is not currently addressed. Ethics Application for ethical approval had three phases. First, we sought approval from the University of Westminster research office to obtain a letter of sponsorship. The application was then submitted to the NHS Research Ethics (Fulham Committee) for proportionate review, where favourable opinion subject to minor amendments was issued (reference no 14/LO/0169). Finally,

we obtained NHS management approval from the St Georges Healthcare NHS Trust’s Research and Development Office to allow the study to be conducted on the Queen Mary’s site (approval was granted in January 2014, reference no.14.0007). Discussion This mixed methods study provides an opportunity

to undertake a comparative analysis of the gender similarities and differences in help-seeking decision-making for non-acute cardiac symptoms, while taking into account the wider factors (eg, emotions, personal relations, perceptions of cardiac risk, culture) that are thought to affect both gender constructs and help-seeking decisions. While there have been many studies within this field, none have sought to evaluate the non-acute context, and no such studies compare men and women. Uncovering the barriers and enablers to men and women seeking help for the early signs of cardiac symptoms is of considerable public health importance, as there is a potential to reduce the risk of acute cardiac

syndrome (ACS). ACS events are known to increase mortality and morbidity. They are associated with heart muscle damage which can lead to heart failure; myocardial scarring is associated with arrhythmic events and, in some cases, sudden cardiac death events. Some types of ACS treatments are linked to severe bleeding complications. The prevention of an ACS is a better option (in terms of patient well-being and Anacetrapib financial cost) than treatment and management after an ACS event. Being able to capture patients in the early stages of heart disease by improving awareness and promoting behavioural change (eg, early presentation enabling ‘non-emergency’ treatments) could significantly improve the long-term clinical outlook. In order to examine the participant’s help-seeking decision process, the study will use qualitative semistructured interviews interpreted with a social construction viewpoint. This is considered the best method for extracting rich data from participants and understanding the meaning participants attach to their cardiovascular experience when little is understood.