The Decisional Balance Toward Health Behaviors Among Patients With Hypertension

AlOsta M, Othman EH, Hamadneh S. Cardiovascular Disease Risk Factors Awareness among Women with a History of Preeclampsia in Jordan

Introduction

Preeclampsia is a pregnancy-specific hypertensive disease that affects 3-5% of pregnant women all over the world and 1.3% of pregnancies among Jordanian women.

Objectives

This study aims to assess the cardiovascular disease risk factors awareness among women with a recent history of preeclampsia in Jordan and assess the role of healthcare providers in providing counseling about cardiovascular disease risk factors.

Methods

A descriptive cross-sectional design was used to recruit 180 women with a recent history of preeclampsia during the last 12 months. Data were obtained from patients' medical records and the Attitude and Beliefs about Cardiovascular Disease Risk Questionnaires.

Results

The results revealed that 43.9% of women with a recent history of preeclampsia have hypertension, 6.7% have diabetes mellitus, 16.1% have dyslipidemia, 28.9% have a family history of cardiovascular disease, 66.1% are overweight or obese, and 7.2% are smokers. The mean total score of knowledge subscale was 5.5 (SD  =  1.21) out of 8. Only 20% of the participants had good cardiovascular disease knowledge. The mean total score of risk perception was 15.47 (SD  =  7.8). The mean score of perceived benefits and intention to change behaviors was 2.30 (SD  =  0.62). The mean score of healthy eating intentions was 2.54 (SD  =  0.81). Income, having diabetes mellitus, and receiving counseling about preeclampsia as cardiovascular disease risk factor were associated with some dimensions of cardiovascular disease risk factors awareness.

Conclusion

The prevalence of cardiovascular disease risk factors was relatively high among the study participants. The majority of participants had inadequate cardiovascular disease knowledge. In addition, the role of healthcare providers in providing counseling about cardiovascular disease and related risk factors, including PE was limited. Providing more counseling related to cardiovascular disease by nurses and doctors is essential to enhance women's cardiovascular disease knowledge and intention to change lifestyle.

Validation and results of a novel survey assessing decisional balance for a whole food plant-based diet among US adults

Importance

Consuming a whole food plant-based diet (WFPBD) is a promising, low-risk strategy for reducing risk of prevalent chronic disease and certain cancers, with synergistic benefits for climate and environment. However, few US adults report consuming a WFPBD. Understanding the reasons for this inconsistency is important for developing and implementing interventions for promoting a WFPBD. However, no research to elucidate decisional balance driving current consumption patterns in the US exists.

Objective

This research aims to validate an online survey to assess decisional balance for the consumption of a WFPBD, describe attitudes and beliefs toward adopting a WFPBD, and evaluate socio-demographic differences in decisional balance for consuming a WFPBD among a convenience sample of US adults.

Design

Online cross-sectional data collection followed by confirmatory factor analysis (CFA), validation of internal consistency, and examination of invariance across socio-demographic variables. Sensitivity analysis of full vs. truncated survey to predict self-reported dietary patterns and consumption behaviors were evaluated. Results of the survey and significant differences by socio-demographics were assessed.

Setting

Online survey based on previous research, created via Qualtrics, and administered through MTurk.

Participants

A total of 412 US adults, majority female (66%), White (75%), 30-60 years old (54%), ≥ Bachelor's degree (85%), and earning ≥ $45K (68%).

Main outcomes and measures

Factor loadings, covariance of survey items, associations with self-reported dietary pattern and consumption measures, and differences in pros, cons, and decisional balance across socio-demographic variables.

Results

CFA reduced the survey from 49 to 12 items and demonstrated invariance across socio-demographic variables. Pros and cons varied inversely and significantly (cov = -0.59), as expected. Cronbach's α 's for subscales in the final, reduced model were high (>0.80). Pros, cons, and decisional balance in both the full and the reduced model were significantly (p < 0.05) associated with self-reported dietary pattern and consumption.

Conclusion and relevance

Our analyses indicate the WFPBD Survey is a parsimonious and psychometrically sound instrument for evaluation of decisional balance to consume a WFPBD diet among our sample of US adults. These results may be instrumental for development and deployment of interventions intended to promote consumption of a WFPBD in the US.