Predictors of acute coronary syndrome symptom knowledge, attitudes, and beliefs in adults without self-reported heart disease

•Hispanic/Latino participants had lower knowledge and attitudes scores than non-Hispanic/Latino.•Teaching of ACS symptom information by health professional predicted knowledge, attitudes, and beliefs.•Variables related to social determinants of health were important predictors of knowledge, attitudes, and beliefs. The time of symptom onset to the time an individual decides to seek care is the most significant contributor to total treatment delay. To explore predictors of ACS symptom knowledge, attitudes, and beliefs in adults without diagnosed heart disease. We used a cross-sectional, descriptive, and correlational design, employing an online survey including the ACS Response Index and the avoidance subscale of the Coping Strategy Indicator. We leveraged social media platforms and a university email list-serv to enroll participants. Stepwise hierarchical linear regressions were used. We analyzed responses from 981 participants, with a mean age of 35.2 years (SD 16.5) and 75% female. The regression analyses yielded models that explained 14%, 23%, and 25% of the variance for knowledge, beliefs, and attitudes, respectively. Ethnicity, race, exposure to ACS symptom information (in the media or by teaching), and perceived health were the predictors of ACS symptom knowledge, attitudes, and beliefs with the largest effect, though others were statistically significant. The findings underscore the importance of community education to raise awareness of ACS symptoms while considering social determinants of health. Future research and clinician interventions for ACS symptom knowledge, attitudes and beliefs should be expanded with a focus on ethnicity and gender.