Knowledge of young African American adults about heart disease: a cross-sectional survey

Health Belief Model Predicts Likelihood of Eating Nutrient-Rich Foods among U.S. Adults

Despite decades of messaging, most Americans still consume excess fats and sugars, but inadequate fiber, potassium, and calcium. Nutrient-rich foods (NRFs) have a high density of favorable nutrients related to calories. Choosing NRFs could lower risk of nutrition-related chronic diseases and aid in their control. We hypothesized that having greater knowledge of NRFs, the presence of a nutrition-related chronic disease or risk factor, and positive Health Belief Model (HBM) views would be predictive of the likelihood of eating NRFs. Through a national online survey panel, 976 adults aged 18-80 completed demographic, health, NRF knowledge, attitudes, and HBM construct questions. Participants were 77% White, 52% women, and 55% had a nutrition-related disease or risk factor. Multivariable HBM scales were generated by theory, principal components, and reliability analysis. NRF knowledge was significantly higher for women, Whites, households without children, and persons without a nutrition-related disease (all p ≤ 0.015). 'Likelihood of eating NRFs' was significantly higher for persons with a nutrition-related disease, Whites, married participants, main food shoppers, and households with children (all p ≤ 0.022). Regressing demographic and HBM constructs on the 'likelihood of eating NRFs' resulted in R2 of 0.435. Nutrition-related disease and HBM constructs of self-efficacy, perceived benefits, and cues to action were predictive of the likelihood of eating NRFs, but higher NRF knowledge was negatively associated.

Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease: Development of a Situation-Specific Theory for African American Emerging Adults

BACKGROUND

Emerging adulthood (18-25 years old) is a distinct developmental period in which multiple life transitions pose barriers to engaging in healthy lifestyle behaviors that reduce cardiovascular disease risk. There is limited theory-based research on African American emerging adults.

OBJECTIVE

This article introduces a synthesized empirically testable situation-specific theory for cardiovascular disease prevention in African American emerging adults.

METHODOLOGY

Im and Meleis' integrative approach was used to develop the situation-specific theory.

RESULTS

Unlocking Population-Specific Treatments to Render Equitable Approach and Management in Cardiovascular Disease is a situation-specific theory developed based on theoretical and empirical evidence and theorists' research and clinical practice experiences.

DISCUSSION

African American emerging adults have multifaceted factors that influence health behaviors and healthcare needs. Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease has the potential to inform theory-guided clinical practice and nursing research. Recommendations for integration in nursing practice, research, and policy advocacy are presented. Further critique and testing of the theory are required.

Dissemination trial for Health for Hearts United: Model development, preliminary outcomes and lessons learned

Background

Cardiovascular disease CVD), the leading cause of death in the U.S., is a particular problem for African Americans (AAs). Church-based health interventions are effective in reducing CVD risk, yet few have been successfully disseminated. This paper describes the model development, preliminary health outcomes, and lessons learned from the Health for Hearts United (HHU) dissemination trial which evolved from the longitudinal Reducing CVD Risk Study in a two-county area in North Florida. Community-based participatory research approaches and the socio-ecological model guided the study.

Methods

Data for this paper were from health leaders (n = 25) in the first six churches investigated, and the outreach participants (n = 86) they engaged. Health leaders completed survey items (daily servings of fruits/vegetables [F/V], fat consumption [FAT], and daily minutes of physical activity [PA]) and clinical measures (body mass index [BMI]; waist, hip and abdomen circumferences; and systolic and diastolic blood pressure [BP]). For outreach participants, a brief CVD Awareness Quiz was administered. Data were analyzed using description statistics, Pearson correlations, and repeated measures analysis of variance.

Results

Findings showed that the dissemination model was implemented by 100% of the churches, and resulted in health outcomes changes for health leaders (significant increases between pre- and post-test in F/V; significant decreases in FAT, BMI, abdomen circumference, with educational level and marital status as selected significant covariates) and in a significant increase in CVD awareness for outreach participants. Lessons learned are discussed. Although preliminary, the results suggest that the HHU dissemination model has promise for reducing CVD risk in AA's.

Latent class cluster analysis of knowledge on acute myocardial infarction in community residents: a cross-sectional study in Tianjin, China

OBJECTIVE

Public knowledge of early onset symptoms and risk factors (RF) of acute myocardial infarction (AMI) is very important for prevention, recurrence and guide medical seeking behaviours. This study aimed to identify clusters of knowledge on symptoms and RFs of AMI, compare characteristics and the awareness of the need for prompt treatment.

DESIGN

Multistage stratified sampling was used in this cross-sectional study. Latent GOLD Statistical Package was used to identify and classify the respondent subtypes of the knowledge on AMI symptoms or modifiable RFs. Multivariable logistic regression was performed to identify factors that predicted high knowledge membership.

PARTICIPANTS

A structured questionnaire was used to interview 4200 community residents aged over 35 in China. 4122 valid questionnaires were recovered.

RESULTS

For AMI symptoms and RFs, the knowledge levels were classified into two or three distinct clusters, respectively. 62.7% (Symptom High Knowledge Cluster) and 39.5% (RF High Knowledge Cluster) of the respondents were able to identify most of the symptoms and modifiable RFs. Respondents who were highly educated, had higher monthly household income, were insured, had regular physical examinations, had a disease history of AMI RFs, had AMI history in immediate family member or acquaintance or had received public education on AMI were observed to have higher probability of knowledge on symptoms and RFs. There was significant difference in awareness of the prompt treatment in case of AMI occurs among different clusters. 'Calling an ambulance' was the most popular option in response of seeing others presenting symptoms of AMI.

CONCLUSIONS

A moderate or relatively low knowledge on AMI symptoms and modifiable RFs was observed in our study. Identification of Knowledge Clusters could be a way to detect specific targeted groups with low knowledge of AMI, which may facilitate health education, further reduce the prehospital delay in China and improve patient outcomes.

Cardiovascular Risk Perception and Knowledge among Italian Women: Lessons from IGENDA Protocol

A multicenter, cross-sectional observational study (Italian GENder Differences in Awareness of Cardiovascular risk, IGENDA study) was carried out to evaluate the perception and knowledge of cardiovascular risk among Italian women. An anonymous questionnaire was completed by 4454 women (44.3 ± 14.1 years). The 70% of respondents correctly identified cardiovascular disease (CVD) as the leading cause of death. More than half of respondents quoted cancer as the greatest current and future health problem of women of same age. Sixty percent of interviewed women considered CVD as an almost exclusively male condition. Although respondents showed a good knowledge of the major cardiovascular risk factors, the presence of cardiovascular risk factors was not associated with higher odds of identifying CVD as the biggest cause of death. Less than 10% of respondents perceived themselves as being at high CVD risk, and the increased CVD risk perception was associated with ageing, higher frequency of cardiovascular risk factors and disease, and a poorer self-rated health status. The findings of this study highlight the low perception of cardiovascular risk in Italian women and suggest an urgent need to enhance knowledge and perception of CVD risk in women as a real health problem and not just as a as a life-threatening threat.

Does Ones Socioeconomic Status Predispose to the Development of Stress Induced Cardiomyopathy?

INTRODUCTION

Stress-induced cardiomyopathy (SIC), known as Takotsubo Cardiomyopathy, presents with chest pain and ECG changes suggestive of an acute myocardial infarction, triggered by physical or emotional stress. SIC has a higher incidence in Caucasians (CAUC) than in African Americans (AA). It is unclear whether this disparity is due to a racial predisposition, selection bias or a consequence of environmental factors.

HYPOTHESIS

We hypothesize that people from a lower socioeconomic strata (SES) have a lower incidence of SIC. Furthermore it is possible that the incidence of SIC could be similar among CAUC and AA at the same SES. Stress pre-conditioning maybe protective in preventing SIC among AA.

METHODS

Data of patients with discharge diagnosis of SIC were extracted from the Myocardial Infarction Data Acquisition System (MIDAS) spanning the period from 2006 through 2015. The incidence of SIC amongst CAUC and AA was compared per 100,000 NJ population. The incidence of SIC in CAUC and AA was examined across income brackets. Comparisons between CAUC and AA were performed with two-sample proportion tests.

RESULTS

During the study period CAUC had an overall higher incidence of SIC compared to AA, 0.017% vs 0.0084% per 100,000 population (p-value < 0.0001). This difference persisted after logistic regression adjustment (P=0.0064). CAUC in the income brackets 30-40k had lower incidence of SIC than those in 60-80k (P=0.0156) and those with income 60-80k had lower incidence of SIC than those with income 80-100k. AA with income between 30-60k had a lower incidence of SIC than CAUC (P=0.0330).

CONCLUSIONS

In this study only CAUC exhibited a trend towards less SIC as a function of lower income level. This was not observed amongst AA however, compared to previously published data AA had a lower incidence of SIC. Our study suggests that SES has a protective effect amongst CAUC, however AA may have other, yet to be defined, stress pre-conditioning factors that are protective.

Cardiovascular Diseases Healthy Diet Related Knowledge among a Sample of the General Population in Egypt

BACKGROUND: Little is known about the extent of Egyptians’ awareness regarding the relationship between nutrition and cardiovascular health. AIM: This study seeks to evaluate people’s awareness through an online cross-sectional survey to determine the knowledge gaps. METHODS: This cross-sectional study was conducted through an online survey using a convenience sampling technique. The participation required being an adult Egyptian (≥18 years old). A pre-tested electronic-questionnaire included three sections: Socio-demographic data, a self-reported history of chronic and cardiac diseases, and 15 questions addressing dietary risk factors and protective factors. Six hundred and thirty-two participants completed the questionnaire. RESULTS: The mean age was 28 ± 8 years. More than 80% of the participants were males. Of 632 participants, 233 had poor awareness. The median knowledge percent score was 62 with interquartile range (52, 71). About 85.4% of the participants were ready to change their eating habits and follow a healthy diet to maintain their health. The participants were interested in knowing more about healthy food and how to prepare healthy balanced meals (71.7% and 62.2%, respectively). Females, university-educated, employed, and Upper Egypt residents demonstrated deep awareness (p-value = 0.02, 0.011, 0.05, and 0.012, respectively). Intriguingly, friends and social media were the primary sources of nutritional knowledge. CONCLUSION: The participants’ knowledge is poor regarding the relation between nutrition and cardiovascular health. This study emphasizes the urgent need to raise public awareness as a precaution against cardiovascular diseases.

Knowledge of Heart Disease, Preventive Behavior and Source of Information in a Multi-ethnic Asian Population: A Population-Based Survey

Several population-based studies have been conducted to better understand the public knowledge of cardiovascular disease (CVD) and behavior. However, most studies have predominantly focused on Western populations. This study aimed to investigate heart disease knowledge, preventive behavior and source of information on heart disease in a multi-ethnic Asian population. We conducted a nation-wide population-based survey of 1000 participants of three ethnic groups (Chinese, Malay, Indian) in Singapore. A structured questionnaire was used to collect sociodemographics, knowledge on CVD risk factors, symptoms, emergency action, preventive health behaviors and sources of information on heart disease. Univariate and multivariate analyses were conducted to identify factors associated with the CVD knowledge and behavior. Knowledge on CVD risk factors was generally high. Knowledge on emergency actions was low particularly in younger people. More than 60% did not meet the recommended levels of physical activity, and this was more evident for individuals of overweight/obese status, lower education and workforce. Chinese were less likely to be obese/overweight compared to the Malays and Indians. Malays were less likely to seek information from internet and social media compared to their ethnic counterparts. This study highlighted heterogeneity in the levels of knowledge and health behavior across population segments, suggesting the need for a tailored approach to heart health interventions and optimal channels for information dissemination. Our findings will form the basis for contextually and culturally appropriate interventions to combat the growing CVD burden and prevent its toll on a rapidly ageing population.

Modelling knowledge, health beliefs, and health-promoting behaviours related to cardiovascular disease prevention among Malaysian university students

Background

Healthy lifestyle habits formed during young adulthood may have a sustaining impact on health across later life. The current study aimed to test the theoretical model of factors (selected demographic variables, knowledge of heart disease, health belief related to cardiovascular disease (CVD), self-efficacy, cues to action, and screening intention) influencing health-promoting behaviours among Malaysian university students.

Methods

In a cross-sectional survey, the undergraduate students in Universiti Sains Malaysia were invited to complete the self-administered questionnaires. Participants were selected using a purposive sampling method. The proposed hypothesised model was analysed using a structural equation modelling with Mplus 7.3 program. A total of 788 (70.7% female) undergraduate students with a mean age of 20.2 (SD = 1.02) participated in the study. The primary outcome of knowledge, health beliefs, and health-promoting behaviours related to CVD were measured by questionnaires namely: Knowledge of Heart Disease, Health Beliefs Related to CVD, and Health Promoting Lifestyle Profiles-II.

Results

The final hypothetical structural model showed a good fit to the data based on several fit indices: with comparative fit index (CFI) at .921, standardised root mean square residual (SRMR) at .037, and root mean square error of approximation (RMSEA) at .044 (90% CI: .032, .054). The final structural model supported 13 significant path estimates. These variables explained 12% of the total variance in health-promoting behaviours. Through perceived benefits, total knowledge had an indirect effect on health-promoting behaviours.

Conclusion

The results suggest that perceived barriers, perceived benefits, family history of CVD, and screening intention enable young adults to engage in health-promoting behaviours.

Knowledge and Prevalence of Heart Disease Risk Factors Among Staff of a Tertiary Institution in Nigeria

BACKGROUND

Cardiovascular disease is the most common cause of mortality worldwide. Hence, awareness of cardiovascular risk factors is an essential step towards effective reduction of the disease burden. This study determined the knowledge and prevalence of cardiovascular risk factors among Staff of Ekiti State University. Ado-Ekiti, Nigeria.

METHODS

A cross-sectional study which comprised of 223 members of staff.

RESULTS

There were 103 males (46.2%). Low knowledge of heart disease risk factors was found in 68.6% of the respondents. The prevalence of hypertension, diabetes mellitus, overweight, obesity, physical inactivity was 35.4%, 12.1%, 31.8%, 23.3%, and 83% respectively. Family history of hypertension was a predictor of a high level of knowledge.

CONCLUSION

A low level of knowledge and increasing prevalence of cardiovascular risk factors existed among staff of Ekiti State University, Nigeria. Hence, there should be a step-up of awareness campaigns and promotion of healthy lifestyle among this category of people.

Young Women's Perceptions of Heart Disease Risk

PURPOSE

Heart disease is the number one cause of death in women. Little is known about how adolescent and young adult women perceive their risk of heart disease.

METHODS

We conducted eight online, semistructured focus groups with 35 young women aged 15-24 years recruited from two primary care practices in Boston, MA. Focus group discussion topics built upon data from a larger sample of women who completed the American Heart Association Women's Health Study survey. Topics included health concerns salient to young women, perceived susceptibility to heart disease, and barriers to heart-healthy behaviors. We used qualitative coding and thematic analyses to synthesize data.

RESULTS

Participants were surprised to learn that heart disease is the leading cause of death in women. Young women discussed age ("I feel like those are things I associate with older people like 40"), gender ("I usually hear more about men suffering from heart problems than women"), and social norms ("we're so pressured just to grow up and [be] more focused on pregnancies or depression or our weight") as reasons for their low perceived risk for heart disease. Participants noted several barriers to adopting heart-healthy behaviors including stress, lack of time, and low perceived risk. "We just don't have time to worry about hearts. Especially if our hearts aren't bothering us to begin with and we can't see it."

CONCLUSIONS

Perceptions of age, gender, and social norms contribute to low heart disease awareness among young women, which in turn may limit heart-healthy behaviors.

The effectiveness of mindfulness-based intervention on perceived stress and perception of disease in patients with acute coronary syndrome

CONTEXT

One of the most important issues in patients with coronary artery disease is their mental health indices such as perceived stress and perception of disease.

AIMS

The aim of this study was to evaluate the effectiveness of mindfulness-based intervention on the perceived stress and disease perception of patients with acute coronary syndrome.

MATERIALS AND METHODS

This is a clinical trial, two-group, and three-stage study on 76 patients with acute coronary syndrome who were randomly divided into intervention and control groups. Nine weekly sessions of mindfulness-based training program were administered to the intervention group. The control group received routine services during this period. Data collection was done before, immediately, and 1 month after the intervention, using the Perceived Stress Scale and the Illness Perception Questionnaire. Data were analyzed using descriptive and inferential statistics.

RESULTS

There was no significant difference between the mean scores of perceived stress and illness perception before intervention. After the intervention and 1 month after it, the mean score of perceived stress in the intervention group was statistically significantly lower than the control group (P < 0.001), and the perception of disease in the intervention group was statistically significantly higher than that of the control group (P < 0.001).

CONCLUSIONS

It is worthwhile to suggest the mindfulness-based training program to reduce the perceived stress and correct the perception of disease for patients with acute coronary syndrome.

Using an educational program based on health belief model to improve the preventive behaviors of nurses against cardiovascular diseases

BACKGROUND

An unhealthy lifestyle can threaten the health of nursing staff, especially in the context of cardiovascular diseases (CVDs). Considering the importance of health education in promoting preventive behaviors against these diseases, this study aimed to evaluate the effect of an educational program based on the health belief model (HBM) on improving preventive behaviors of nurses against CVDs.

MATERIALS AND METHODS

This is a randomized controlled trial with a pretest-posttest design conducted on 104 nursing staff of Imam Khomeini Hospital in Kuhdasht, Lorestan, Iran, in 2017. They were randomly assigned into two groups of HBM (n = 52) and control (n = 52). The HBM group received the educational intervention for 6 weeks, one session per week each for 30-40 min. They were measured before and after the intervention using a demographic form, a researcher-made HBM questionnaire, Baecke Habitual Physical Activity Questionnaire, and the 3-day food intake record all in Persian. The collected data were analyzed in the Statistical Package for the Social Sciences (SPSS) v. 24 software using the Chi-squared test and paired t-test.

RESULTS

The educational program could only increase the perceived severity (22.64 ± 2.22), perceived benefits (50.83 ± 5.22), and perceived self-efficacy (42.37 ± 5.93) of nurses in the HBM group compared to the controls (P < 0.05). The nurses' perceived sensitivity was also increased, but it was not significant (P > 0.05). In the HBM group, a significant change was found in the food intake level for energy (t = 4.79, P = 0.000), protein (t = -2.99, P = 0.004), and unsaturated fat (t = -2.94, P = 0.005) after intervention. No significant difference was observed in the total physical activity score after the intervention (P > 0.05).

CONCLUSION

An educational program based on the HBM model can be used to increase the severity, benefits, and self-efficacy of the nurses' preventive behaviors against CVDs and modify their dietary regime.

Life's simple 7 and cardiovascular disease risk knowledge in Hong Kong

BACKGROUND

This study aimed at investigating the CV health and CV disease knowledge in terms of LS7 score among 3 age groups in Hong Kong.

METHODS

A cross-sectional multicenter observational study was conducted to observe the CV health and disease risk knowledge in Hong Kong. Elderly subjects were recruited from 15 elderly centers, whereas young adults and the middle-aged were recruited from 6 on-campus health check sessions. Subjects' demographics, lifestyle behavior and risk knowledge were obtained through questionnaire while their body mass index, random capillary blood glucose, blood cholesterol and blood pressure were measured. LS7 score and risk knowledge score was calculated.

RESULTS

The LS7 of younger adult, middle-aged and elderly were 10.6 ± 1.3, 9.3 ± 1.9 and 9.7 ± 1.7 respectively. Only 0.6% participants have attained ideal CV health and 35.9% have 5 to 7 ideal CV health metrics. Elderly performed worst in risk knowledge with a score of 8.1 ± 3.3 while young adult and middle-aged were similar (9.6 ± 1.8 and 9.7 ± 1.5). 71% of the participants correctly identified ≥9 components. Logistic regression revealed that subjects aged ≤65 years (OR 2.341, 95% CI 1.779 to 3.080) and with tertiary education (OR 2.031, 95% CI 1.527 to 2.701) were more likely to obtain optimum LS7. No association was found between having optimum LS7 and full knowledge.

CONCLUSION

Only few adults in this study population had ideal CV health as defined by AHA. Knowledge has no association but young age and tertiary education has positive association with CV health.

Differences in Cardiovascular Risk Factors in College Students: Midwest Versus Southwest

PURPOSE

This study was designed to identify underlying cardiovascular risk factors among college students including lifestyle characteristics, health behaviors and knowledge, and perception of the risk factors.

METHOD

College students (N = 293), aged 19-36 years, enrolled at either a Midwestern or a Southwestern University in the United States, responded to three questionnaires: sociodemographic, knowledge of cardiovascular risk factors, and perception of cardiovascular risk factors. Anthropometric measures collected included blood pressure (BP), glucose, lipid panel, height, weight, and body mass index (BMI).

RESULTS

There were significant regional and gender differences in cardiovascular disease (CVD) risk among Southwestern and Midwestern college students. Students from the Southwest had a higher risk of developing CVD in 30 years compared to those in the Midwest; they also had a higher perceived risk. Males were more at risk of developing CVD than females but had a lower perceived risk than females. Dietary habits were similar between the two populations, and we found no significant differences in BMI. The two regions varied in BP levels, but the Midwestern students had significantly higher prevalence of elevated BP and Stage 2 hypertension.

CONCLUSION

Our data suggest that college students are a high-risk population and tend to underestimate and misperceive their risk for developing CVD.

Cardiovascular Risk, Risk Knowledge, and Related Factors in Patients With Type 2 Diabetes

Individuals with diabetes must be informed about cardiovascular diseases (CVDs), which is the most important cause of mortality of diabetes, and the interventions should be planned according to their risk status. The aim of this study was to investigate cardiovascular risk, risk knowledge, and related factors in patients with type 2 diabetes. A total of 188 participants were included in this descriptive study. Data were collected using Heart Disease Fact Questionnaire (HDFQ) and Systematic Coronary Risk Evaluation (SCORE) Calculator. Spearman test and multiple regression analysis were used for statistical analysis. Participants did not have sufficient knowledge related to CVD risk factors, and they were in the moderate CVD risk group. CVD risk was lower in subjects with high level of knowledge regarding CVD risk and lower duration of diabetes. Our findings highlight the need for interventions related to CVD, which can reduce its risk. These interventions can be specifically targeted at individuals with advanced age, a long duration of diabetes, low education level, and decreased metabolic control.

Health Beliefs Regarding Cardiovascular Disease Risk and Risk Reduction in South Asian Immigrants: An Integrative Review

Introduction: The risk for cardiovascular disease (CVD) is higher in South Asians (SAs) than in other ethnic groups. The purpose of this review is to explore SAs' health beliefs regarding CVD risk and risk reduction behaviors including physical activity and healthy diet. Methodology: An integrative review was conducted to examine the peer-reviewed literature published before May 2017. Searches from PubMed, Scopus, and CINAHL yielded 1 mixed-method, 4 quantitative, and 14 qualitative studies. Results: Stress, lack of exercise, and high-fat diet were perceived as causes of CVD in most studies. Lack of time, sociocultural norms, and insufficient guidance from health care providers were perceived barriers to CVD risk reduction. Exercise and healthy diet were perceived to be beneficial in a few studies. Cues to action included information from community leaders and health care providers. Discussion: Understanding the unique health beliefs of SAs regarding CVD is important in planning and delivering culturally competent preventive and educational services.

Perceptions of Heart-Healthy Behaviors among African American Adults: A Mixed Methods Study

African Americans have a disproportionately higher risk of chronic conditions such as cardiovascular disease (CVD), type 2 diabetes, and hypertension than other ethnic or racial groups. Data regarding CVD-related perceptions and beliefs among African Americans are limited, particularly in the Southwest US. Assessment of current views regarding health and health behaviors is needed to tailor interventions to meet the unique needs of specific populations. We sought to examine knowledge, attitudes, and perceptions of African Americans living in Arizona toward CVD and etiological factors associated with health behaviors and chronic disease development to inform state health agency program development. Transcripts from 14 focus groups (n = 103) were analyzed using Grounded Theory for perceived disease risk, knowledge of CVD risk factors, nutrition, preventative behaviors, and barriers and motivators to behavior change. Participants identified CVD, stroke, and diabetes as leading health concerns among African-Americans but were less certain about the physiological consequences of these diseases. Diet, stress, low physical activity, family history, hypertension, and stroke were described as key CVD risk factors, but overweight and obesity were mentioned rarely. Participants described low socio-economic status and limited access to healthy foods as contributors to disease risk. Focus group members were open to modifying health behaviors if changes incorporated their input and were culturally acceptable. Respondents were 41% male and 59% female with a mean age of 46 years. This study provides insight into CVD and associated disease-related perceptions, knowledge, and attitudes among African Americans in the Southwest and recommendations for interventions to reduce CVD risk.

Design and standardization of tools for assessing the perceived heart risk and heart health literacy in Iran

Objectives:

The aim is to achieve the standard tools for heart health, the present study aimed to design, develop, and standardize the two questionnaires of perceived heart risk scale (PHRS) and heart health literacy scale (HHLS).

Methods:

The present study was a methodological research conducted on the residents of Kermanshah Province, Iran, using the multi-stage cluster sampling. Further, considering the scientific methods in the psychometric field, the design of the research questionnaires was conducted. In addition, the viewpoints of experts in different domains were qualitatively and quantitatively included to assess the validity of the questionnaires. To assess the reliability of the questionnaires, a sample including 31 subjects was first selected and studied within a fortnight's interval. Then, the reliability and validity of the scales were assessed using factor analysis and Cronbach's alpha in a sample of 771 subjects.

Results:

After reviewing the viewpoints of experts, the items were adjusted and implemented in the first sample at two stages. The results were indicative of the stability and acceptability of the Cronbach's alpha. In addition, the validity and reliability of the questionnaires were confirmed in the second sample too.

Conclusion:

According to the results of the present study, it can be concluded that the two questionnaires of PHRS and HHLS had acceptable reliability and validity.

Knowledge, Attitude, and Practice Regarding the Risk of Cardiovascular Diseases in Patients Attending Outpatient Clinic in Kuantan, Malaysia

Background:

Cardiovascular disease (CVD) is a leading cause of death around the world including Malaysia. Ischemic heart disease (IHD) is the single largest cause of death in the developed countries and is one of the main contributors to the disease burden in developing countries.

Materials and Methods:

This was a cross-sectional study conducted to determine knowledge, attitude, and practice (KAP) regarding the risk of CVD in patients attending an outpatient clinic in Kuantan, Malaysia. A total of 100 patients comprising 52 male and 48 female subjects were selected through convenient sampling method.

Results:

Of the total subjects, 86% were Malays. The mean scores (standard deviation) for KAP were 60.75±4.823, 54.36±8.711, and 33.43±4.046, respectively, whereas the maximum scores obtained by the subjects for KAP were 71, 65, and 43, respectively. Regarding questions related to knowledge, 88% subjects knew irregular eating pattern can cause disease and the benefits of vegetable intake. Most subjects recognized that smoking and obesity were CVD risk factors. Regarding questions related to attitude, 96% agreed that exercise can prevent CVD. More than half of the subjects followed healthy lifestyle. There were statistically significant differences observed in knowledge level between sexes (P = 0.046) and races (P = 0.001). Nevertheless, there was no statistically significant difference observed in KAP across different education levels of the subjects regarding the risk of CVD (P-value = 0.332, 0.185, and 0.160, respectively).

Conclusion:

This study revealed that patients had good knowledge and attitude regarding CVD risk factors. Yet, the number of smokers is still quite high. Development of better public information system is essential for the well-being of the society.

Exploratory study into awareness of heart disease and health care seeking behavior among Emirati women (UAE) - Cross sectional descriptive study

Background

Cardiovascular disease was the leading cause of death among women in the United Arab Emirates (UAE) in 2010. Heart attacks usually happen in older women thus symptoms of heart disease may be masked by symptoms of chronic diseases, which could explain the delay in seeking health care and higher mortality following an ischaemic episode among women. This study seeks to a) highlight the awareness of heart diseases among Emirati women and b) to understand Emirati women’s health care seeking behaviour in UAE.

Method

A cross sectional, descriptive study was conducted using a survey instrument adapted from the American Heart Association National survey. A convenience sample of 676 Emirati women between the ages of 18–55 years completed the questionnaire.

Results

The study showed low levels of awareness of heart disease and associated risk factors in Emirati women; only 19.4% participants were found to be aware of heart diseases. Awareness levels were highest in Dubai (OR 2.18, p < 0.05) among all the other emirates and in the 18–45 years age group (OR 2.74, p < 0.05). Despite low awareness levels, women paradoxically perceived themselves to be self-efficacious in seeking health care. Interestingly, just 49.1% Emirati women believed that good quality and affordable health care was available in the UAE. Only 28.8% of the participants believed there were sufficient female doctors to respond to health needs of women in UAE. Furthermore, only 36.7% Emirati women chose to be treated in the UAE over treatment in other countries.

Conclusion

Emirati women clearly lack the knowledge on severity and vulnerability to heart disease in the region that is essential to improve cardiovascular related health outcomes. This study has identified the need for wider outreach that focuses on gender and age specific awareness on heart disease risks and symptoms. The study has also highlighted potential modifiable barriers in seeking health care that should be overcome to reduce morbidity and mortality due to heart disease among national women of UAE.

Analyzing cardiovascular treatment guidelines application to women and minority populations

Despite nearly 30 years of treatment guidelines for cardiovascular diseases and risk factors and a parallel growth in the understanding of cardiovascular disease disparities by sex and race/ethnicity, such disparities persist. The goals of this review are to consider the possible role of three factors: the one-size-fits-all approach of most treatment guidelines, adoption of guideline-recommended treatments in clinical practice, and patient adherence to recommended practice, especially the relationship between adherence and patient perceptions. Guideline authors repeatedly call for more inclusion of women and minorities in the clinical trials that make guidelines possible, but despite challenges, guidelines are largely effective when implemented, as shown by a wealth of post hoc analyses. However, the data also suggest that one-size-fits-all treatment guidelines are not sufficiently generalizable and there is evidence of a distinct lag time between definitive clinical evidence and its widespread implementation. Patient perspectives may also play both a direct and indirect role in adherence to treatments. What emerges from the literature is an important continuing need for increased inclusion of women and minority subgroups in clinical trials to allow analyses that can provide evidence for differential treatments when needed. Increased effort is needed to implement definitive clinical improvements more rapidly. Patient input and feedback may also help inform clinical practice and clinical research with a better understanding of how to enhance patient adherence, but evidence for this is lacking for the groups most affected by disparities.

Public knowledge of cardiovascular disease and response to acute cardiac events in three cities in China and India

Objective

To inform interventions targeted towards reducing mortality from acute myocardial infarction (AMI) and sudden cardiac arrest in three megacities in China and India, a baseline assessment of public knowledge, attitudes and practices was performed.

Methods

A household survey, supplemented by focus group and individual interviews, was used to assess public understanding of cardiovascular disease (CVD) risk factors, AMI symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs). Additionally, information was collected on emergency service utilisation and associated barriers to care.

Results

5456 household surveys were completed. Hypertension was most commonly recognised among CVD risk factors in Beijing and Shanghai (68% and 67%, respectively), while behavioural risk factors were most commonly identified in Bangalore (smoking 91%; excessive alcohol consumption 64%). Chest pain/discomfort was reported by at least 60% of respondents in all cities as a symptom of AMI, but 21% of individuals in Bangalore could not name a single symptom. In Beijing, Shanghai and Bangalore, 26%, 15% and 3% of respondents were trained in CPR, respectively. Less than one-quarter of participants in all cities recognised an AED. Finally, emergency service utilisation rates were low, and many individuals expressed concern about the quality of prehospital care.

Conclusions

Overall, we found low to modest knowledge of CVD risk factors and AMI symptoms, infrequent CPR training and little understanding of AEDs. Interventions will need to focus on basic principles of CVD and its complications in order for patients to receive timely and appropriate care for acute cardiac events.

Knowledge of warning signs, presenting symptoms and risk factors of coronary heart disease among the population of Dubai and Northern Emirates in UAE: a cross-sectional study

BACKGROUND

To evaluate the level of knowledge regarding warning signs, presenting symptoms and risk factors associated with coronary heart disease (CHD) among population of Dubai and Northern Emirates in UAE.

MATERIALS AND METHODS

A cross sectional survey of 1367 residents of Dubai and Northern Emirates was conducted using a self-administered questionnaire.

RESULTS

Respondents were classified into two groups: Young Adult Population (YAP; 18-24 years of age) and General Population (GP; 25 years and older). Majority of participants were males (56.7%) and of South Asian (57.5%) or Middle-Eastern (30.8%) ethnicity. Regarding presenting symptoms of CHD, chest pain was identified by around 80% of population, whereas pain in the left shoulder was recognized by 61% of GP and 44% of YAP. Atypical symptoms were poorly identified. Regarding risk factors, only one-fourth population knew that males were at higher risk compared to premenopausal females. Few knew that the risk increases in females after menopause and that the risk is higher for females who smoke and use oral contraceptives. 62% knew that the survivors of a heart attack are at high risk of recurrences. Except for tobacco smoke, hypercholesterolemia and hypertension, knowledge of other risk factors was not satisfactory. Older adults and females had comparatively higher level of knowledge.

CONCLUSION

Knowledge level of many of the symptoms and risk factors of CHD is unsatisfactory. There is, therefore, a need to increase the awareness in the population of UAE. The knowledge gaps identified through this study can be addressed through health campaigns to increase the awareness about warning signs, symptoms and modifiable risk factors. .

Assessment of Knowledge of Critical Cardiovascular Risk Indicators among College Students: Does Stage of Education Matter?

The health risk of college students in the United States (US) is on the rise, with a significant increase in the prevalence of cardiovascular risk factors. Cardiovascular disease is the leading cause of death in the US, costing approximately $475.3 billion yearly. The goals of this “Know Your Numbers” study were to: (1) estimate the awareness of college students of their critical health numbers (CHN); and (2) compare a college of pharmacy entry class (IP1) with second semester non-commuter freshman college students (FCS) in knowing their numbers. A cross-sectional 15-item pre-test survey was conducted among a convenience sample of IP1 and FCS. All statistical tests were performed at α = 0.05. Awareness of their: cholesterol (7%), blood pressure (BP) (35%), glucose (8%), and body mass index (BMI) (42%) were low. The IP1, compared to FCS, were more knowledgeable of: (1) their BP (46% vs. 28%, p = 0.01); (2) BP normal range (74% vs. 63%, p = 0.02); and (3) BMI normal range (39% vs. 23%, p = 0.04). The IP1s maintained a healthier diet than the FCS (64% vs. 36%, p < 0.0001). Awareness of knowing CHN was very low. Knowledge of one’s CHN was significantly associated with knowledge of normal reference values for BP, glucose, and BMI.

Exploratory study into the awareness of heart diseases among Emirati women (UAE) and their health seeking behaviour- a qualitative study

Background

Cardiovascular diseases were the leading cause of death in women in the United Arab Emirates (UAE) in 2010. The UAE is expected to experience a tripling of heart diseases in the next two decades as risk factors for heart diseases increase. Research shows that first year survival rates of younger women suffering from a heart attack are lower than in men. Women present with a wider range of symptoms for heart diseases than men; non-recognition of atypical symptoms may explain the delay in seeking treatment and poor prognosis following heart diseases in women. No known study on awareness of heart diseases among women has been carried out in the Middle Eastern region.

Methods

Social constructionist and interpretivist epistemological approaches have been considered in this qualitative study to explore the awareness of heart diseases and the health seeking behavior of Emirati women. Convenience sampling was used to recruit 41 Emirati women. Three focus groups and six in-depth semi-structured interviews were conducted to obtain data. Thematic content analysis was applied to the data following transcription and translation of recordings.

Results

Emirati women had limited knowledge on heart diseases. Women were generally unaware of the atypical symptoms, commonly experienced by women however they identified most risk factors associated with heart diseases. Lack of awareness of disease severity and symptoms, sociocultural influences and distrust in the healthcare system were considered the main barriers to seeking prompt treatment.

Conclusions

This study clearly identified gaps and inaccuracies in knowledge of heart diseases, which could contribute to delayed health seeking action and possibly poorer prognosis among Emirati women. Absence of initiatives to educate women on cardiovascular diseases in UAE has erroneously deemed it a less serious concern among Emirati women. The findings from this study provide clear indications of the need to increase accountability of the healthcare system and to develop culturally relevant, gender specific, age focused, heart diseases related public health awareness campaigns in UAE.

Electronic supplementary material

The online version of this article (doi:10.1186/s12905-016-0350-2) contains supplementary material, which is available to authorized users.

Predictors of Heart Disease Knowledge Among Older and Younger Asian Indian Adults

Coronary heart disease (CHD) has been estimated to be the leading cause of mortality in developing countries in 2010, particularly among Asian Indians. When compared to other populations globally, Asian Indians less than 40 years of age are at an increased risk of myocardial infarction. The objective of this study was to identify the predictors of knowledge of heart disease among younger and older Asian Indians adults. A cross-sectional survey was undertaken in Sydney Australia. One hundred and forty-four participants of Asian Indian descent who attended the health promotion stall at the Australia India Friendship Fair in Sydney participated in the study. All participants completed a self-administered questionnaire. The Primary outcome of the survey was knowledge of heart disease as measured by the 25 item Heart Disease Facts Questionnaire. All six modifiable risk factors for heart disease namely smoking, high blood pressure, diabetes, high cholesterol, physical inactivity and overweight were identified by 45.2 % of those aged below 40 and 53.5 % of those aged above 40 years of age respectively. For younger adults, only smoking status was significant and was an independently predictor of knowledge related to CHD (b = -10.6, p = 0.001, sr² = 0.16). For older adults, smoking status and duration of residence were significant predictors of knowledge related to CHD (b = -7.4, p = 0.000, sr² = 0.24; b = 0.13, p = 0.001, sr² = 0.069 respectively). Although suboptimal, there were no statistically significant differences in the level of knowledge among older and younger Asian Indians. Nevertheless, strategies to improve the knowledge of heart disease among this cohort are warranted.

Validation of the Knowledge and Perception of Cardiovascular Risk Factors Questionnaires for College Students

BACKGROUND AND PURPOSE

To test the psychometric properties of two measures of knowledge and perception of cardiovascular risk factors (CRFs).

METHODS

A methodological study using a modified version of the Heart Disease Fact Questionnaire (HDFQ) and the Health Beliefs Related to Cardiovascular Disease (HBCVD) questionnaires was administered to 100 college-aged students.

RESULTS

The HDFQ Kuder-Richardson-20 reliability estimate was .73. The HBCVD Cronbach's alpha was .70. Principal component analysis demonstrated the HBCVD questions load onto components representing the perceived susceptibility and severity of CRFs. There was an inverse relationship between knowledge and perception of CRFs (ρ = -.26, p = .009), as knowledge increased, perception of risk decreased.

CONCLUSIONS

The HDFQ and HBCVD questionnaires had adequate internal consistency reliability and documented construct validity for use in college students.

Transition in public knowledge of risk factors of cardiovascular disease in an Iranian general population: A latent transition analysis (LTA) on a longitudinal large community-based educational prevention program

BACKGROUND

Cardiovascular diseases (CVD) are the second leading cause of death, after accidents, in Iran. This study was performed to assess the change in levels of knowledge about 8 risk factors of CVD and its associated determinants the Iranian general population.

METHODS

The current repeated cross-sectional study included 3014 people in 2004, 3012 in 2005, and 4719 in 2007, aged older than 19 years. Knowledge about 8 risk factors (high blood pressure, nutrition, physical inactivity, smoking, diabetes, heredity, stress, and obesity) as the major causes of CVD was evaluated using latent transition analysis (LTA).

RESULTS

The most widely known CVD risk factors were nutrition and physical inactivity followed by stress. In addition, old age, low level of education, male gender and low socioeconomic status (SES) level were the significant determinants of low knowledge levels of CVD risk factors. Besides, individuals' knowledge of CVD risk factors increased across the time.

CONCLUSION

Public knowledge of CVD risk factors has increased; however significant gaps continue to exist, particularly among the elderly, less-educated people, people in low socioeconomic status level and men. Future intensified educational efforts by policymakers are necessary for improving knowledge of CVD, particularly among high-risk groups.

Psychometric Properties of the Heart Disease Knowledge Scale: Evidence from Item and Confirmatory Factor Analyses

BACKGROUND

Heart disease knowledge is an important concept for health education, yet there is lack of evidence on proper validated instruments used to measure levels of heart disease knowledge in the Malaysian context.

METHODS

A cross-sectional, survey design was conducted to examine the psychometric properties of the adapted English version of the Heart Disease Knowledge Questionnaire (HDKQ). Using proportionate cluster sampling, 788 undergraduate students at Universiti Sains Malaysia, Malaysia, were recruited and completed the HDKQ. Item analysis and confirmatory factor analysis (CFA) were used for the psychometric evaluation. Construct validity of the measurement model was included.

RESULTS

Most of the students were Malay (48%), female (71%), and from the field of science (51%). An acceptable range was obtained with respect to both the difficulty and discrimination indices in the item analysis results. The difficulty index ranged from 0.12-0.91 and a discrimination index of ≥ 0.20 were reported for the final retained 23 items. The final CFA model showed an adequate fit to the data, yielding a 23-item, one-factor model [weighted least squares mean and variance adjusted scaled chi-square difference = 1.22, degrees of freedom = 2, P-value = 0.544, the root mean square error of approximation = 0.03 (90% confidence interval = 0.03, 0.04); close-fit P-value = > 0.950].

CONCLUSION

Adequate psychometric values were obtained for Malaysian undergraduate university students using the 23-item, one-factor model of the adapted HDKQ.

Racial/Ethnic Differences in Knowledge of Personal and Target Levels of Cardiovascular Health Indicators

This study aimed to examine ethnic differences in knowledge of personal and target levels of cardiovascular health indicators between non-Hispanic whites and African Americans. A secondary objective was to evaluate the associations between knowledge of cardiovascular health indicators and health promotion behaviors. Participants (66.7% female) consisted of 265 whites and 428 African Americans, ages 18 and older recruited from primary care clinics and churches. Respondents completed a brief survey on blood pressure (BP), total cholesterol, blood glucose, body mass index (BMI), diet, and physical activity. Whites were more likely than African Americans to report knowing their personal and target levels of cardiovascular health indicators. Knowledge of personal BP and/or BMI was positively associated with actual physical activity, and awareness of personal blood glucose was positively associated with healthy dietary practices for participants in both groups. Among whites, awareness of personal BP and knowledge of target levels for BP, total cholesterol, and BMI were also associated with healthy diet. Results suggest there are racial/ethnic disparities in knowledge of personal and ideal levels of cardiovascular health indicators, and that this knowledge is related to health promotion behaviors. Targeted educational efforts are warranted to enhance knowledge of personal risk indicators among African Americans.

Efetividade da intervenção educativa no conhecimento de homens relacionado às doenças cardiovasculares

Resumo Objetivo Comparar o conhecimento sobre fatores de risco para doenças cardiovasculares antes e após intervenção educativa realizada com homens metalúrgicos. Métodos Estudo de intervenção, realizado com 135 metalúrgicos, com idades entre 18 e 70 anos. O conhecimento sobre doenças cardiovasculares foi determinado pelo questionário Heart Disease Fact Questionnaire (HDFQ-2). Foram utilizados testes t de Student para amostras independentes e de Mann-Whitney, na comparação entre grupos, e testes t de Student para amostras dependentes e de Wilcoxon, na avaliação pareada. Resultados Tanto no grupo intervenção quanto no controle houve aumento estatisticamente significativo de 1,4 pontos na média do conhecimento entre o momento de base e o de seguimento. Conclusão A intervenção educativa, realizada em grupo, no local de trabalho e em horário de almoço, mostrou-se uma estratégia possível e eficaz para aumentar o conhecimento de homens sobre fatores de risco para doenças cardiovasculares.

Informing Policy for Reducing Stroke Health Disparities from the Experience of African-American Male Stroke Survivors

BACKGROUND

The burden of stroke is severe among African-Americans. Despite overall declines in the rate of stroke since 2000, outcomes are largely unimproved or have worsened for African-American men. Adverse psychosocial challenges may hinder adherence to a regimen of risk factor reduction.

METHODS AND RESULTS

Focus group analysis was combined with a review of current published guidelines and epidemiologic evidence on risk factors to better understand stroke health disparities and potential policy solutions. Transcripts from three focus groups with ten African-American male stroke survivors under age 65 and their care partners (N = 7) were analyzed and compared with existing published data on (a) the burden of stroke (b) trends in clinical risk factors, and (c) trends in behavioral risk factors. Participants described myriad psychosocial barriers that impede reduction of risk indicators, including low trust in providers, poor social support, access difficulties, depression, and distress.

CONCLUSIONS

In order to be effective, policies and programs must target mechanisms consistent with the challenges faced by African-American men. Infrastructure is needed to better identify and share practices effective for improving cardiovascular outcomes within specific racial and ethnic groups.

Deaf Adolescents' Learning of Cardiovascular Health Information: Sources and Access Challenges

Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health literacy, learn cardiovascular health information and their lived experiences accessing health information. The goal is to ultimately use this information to improve the delivery of cardiovascular health education to this population and other deaf adolescents at a higher risk for weak health literacy. Deaf bilingual researchers interviewed deaf adolescents, transcribed and coded the data, and described the findings. Five major sources of cardiovascular health information were identified including family, health education teachers, healthcare providers, printed materials, and informal sources. Despite possessing advantageous characteristics contributing to stronger health literacy, study participants described significant challenges with accessing health information from each source. They also demonstrated inconsistencies in their cardiovascular health knowledge, especially regarding heart attack, stroke, and cholesterol. These findings suggest a great need for additional public funding to research deaf adolescents' informal health-related learning, develop accessible and culturally appropriate health surveys and health education programming, improve interpreter education, and disseminate information through social media.

Factors associated with knowledge of hypertension among adolescents: implications for preventive education programs in primary care

Background

Hypertension (HT) amongst adolescents remains a vital issue of both a medical and social nature. There is a lack of data regarding the factors influencing the awareness of the disease among the youth. The aim of this study was to evaluate the knowledge about HT among adolescents and its level corresponding to the selected demographic, environmental and medical factors.

Methods

The study was carried out among 250 adolescents of secondary schools. The authors’ questionnaire poll and the psychological tests Personal Values List (PVL) and Personal Competence Scale (PCS) were performed.

Results

Only 13.2% of the youth surveyed displayed the “medium” level (defined below) of HT knowledge. Most of them present satisfactory knowledge about the causes of HT. The children from urban areas generally displayed better knowledge about HT than their peers from rural regions. Only the children who had had their blood pressure previously examined displayed good knowledge about HT. The most frequently indicated source of this knowledge was school; however, its level still remains low. There was no significant association between the level of global knowledge about HT and the feeling of one’s own competences and considering the category “good health” an important personal value.

Conclusions

Knowledge about HT among adolescents remains unsatisfactory and random, which indicates the necessity for routine education in this field, especially as it applies to HT symptoms. It seems that the consideration of such elements as blood pressure measurement and family history of HT in education programs can improve their efficiency.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-1773-7) contains supplementary material, which is available to authorized users.

Knowledge of heart disease risk factors among workers in a Nigerian University: A call for concern

Introduction:

Cardiovascular disease is the commonest cause of mortality worldwide. Many risk factors predate the development of cardiovascular diseases. Adequate knowledge of risk factors for cardiovascular diseases is the first step towards effective preventive strategies to combat the cardiovascular diseases burden in any population. This study aims to determine the knowledge of workers in a Nigerian University on risk factors for cardiovascular diseases.

Materials and Methods:

A cross-sectional survey of 206 academic and non-academic staff of Ladoke Akintola University of Technology, Ogbomoso, Nigeria using the Heart Disease Fact Questionnaire (HDFQ). Demographic data were taken. The lipid profile and random blood sugar were taken. Statistical analysis was done using SPSS 17.0.

Results:

The mean age of the study participants was 45.3 ± 7.9 years. There were 96 males (46.6%). The mean HDFQ score was 48.6%. Only 41 (19.9%) of participants were assessed to have good knowledge of heart disease risk factors. Majority, 101 (49.0%) had poor knowledge while 64 (31.2%) had fair knowledge of heart disease risk factors. There was no significant difference between prevalence of CV risk factors between those with good or fair or low level of knowledge. Most participants did not have a good level of knowledge about risk factors, prevention, treatment and association with diabetes as it relates to heart diseases.

Conclusion:

Knowledge of heart disease risk factors is low among University workers in Nigeria. Effective education on heart disease risk factors and appropriate preventive strategies are indeed important to reduce cardiovascular disease burden in Nigerian University communities.

Cardiovascular diseases and women: knowledge, attitudes, and behavior in the general population in Italy

Background. The objectives of the study were to document knowledge, attitudes, and behaviors of women regarding cardiovascular diseases (CVDs) and the determinants associated. Materials and Methods. The cross-sectional survey was conducted among a random sample of 830 women older than 18 years from the general population in Italy. Results. Almost all participants reported having heard about CVDs, and among them 89.4% and 74.7% identified smoking and high cholesterol level as risk factors. Only 26.5% identified the main CVDs risk factors. Women more knowledgeable were married and better educated and self-perceived a worse health status. Only 23% knew the main CVDs preventive measures and this knowledge was significantly higher in women who are unemployed, who are more educated, who have received information about CVDs from physicians, and who know the main risk factors. Respondents with lower education, those with at least three children, those who self-perceived a worse health status, and those who need information were most likely to have a positive attitude toward the perceived risk of developing CVDs. Women with two or three children or more were at high risk profiles 49% and 56% lower than women with one child. Conclusions. Educational programs are needed among women as support to improve knowledge and appropriate behavior about CVDs.

Cardiac self-efficacy and its predictors in patients with coronary artery diseases

AIMS AND OBJECTIVES

To investigate cardiac self-efficacy and its predictors among patients with coronary artery diseases.

BACKGROUND

Patients with coronary artery diseases must perform the health behaviour to prevent recurrent cardiac events. It has been already well known that self-efficacy is a vital factor in both initiating and maintaining health behaviours.

DESIGN

Descriptive correlational and cross-sectional survey design.

METHODS

Subjects were interviewed using structured study questionnaires. The data collected were statistically analysed by descriptive statistics and inferential statistics including the t-test, anova, Tukey's test, Pearson's correlation and hierarchical multiple regression analysis to determine the predictors of cardiac self-efficacy.

RESULTS

A convenience sample of 214 patients with coronary artery diseases was included. The mean age of subjects was 60·71 ± 10·07 years, and three-fourths were men. The overall model significantly explained 15·8% of variance in cardiac self-efficacy. Among predictors, occupation, diagnosis, body mass index, experience of receiving patient education and awareness of risk factors had statistically significant influences on cardiac self-efficacy.

CONCLUSIONS

Rather than disease knowledge, factors related to subject's perception were more likely to associate with cardiac self-efficacy. These findings might provide a theoretical basis to develop nursing interventions for enhancing cardiac self-efficacy of patients with coronary artery diseases.

RELEVANCE TO CLINICAL PRACTICE

Clinical nurses taking care of patients with coronary artery diseases should consider the patients' perception on their coronary artery diseases including experience of receiving patient education, and awareness of risk factors in encouraging the cardiac self-efficacy to promote the health behaviours for the secondary prevention of coronary artery diseases.

Effect of resistance training on biomarkers of vascular function and oxidative stress in young African-American and Caucasian men

African Americans (AA) have an earlier onset of hypertension and a different vascular profile than their Caucasian (Cau) peers. Research suggests that biological mediators of vascular inflammation are different among these groups in hypertensive populations. Resistance training (RT) is an important exercise modality that improves the vascular profile of young AA men. We examined the role of RT on biomarkers of vascular function and oxidative stress in body mass index-matched AA and Cau men. RT for 6 weeks elicited significant changes in circulating matrix metalloprotease-9 (MMP-9) and 8-Isoprostane (8-IsoP) in young AA men (n=14, AA; n=18, Cau; 18-35 years). MMP-9 was lower and decreased in AA (pre: P=0.02; post: P<0.001) and a time × group interaction for MMP-9 (F(1, 30)=4.81; P=0.036) and 8-IsoP (F(1, 24)=7.09; P=0.014) was detected. 8-IsoP decreased in AA (P=0.026) but did not change in Cau (P=0.309). Notably, the increase in strength (1-repetition maximum (1-RM)) was correlated with the decrease in MMP-9 (r=-0.398; P=0.022). Furthermore, these adaptations were independent of any improvement in cardiorespiratory fitness. We demonstrate that RT effectively reduces matrix remodeling proteins and oxidative stress in young AA men. Increasing strength may be beneficial for improving vascular health and offsetting novel cardiovascular risk factors of hypertension in young AA men.