Knowledge,Preventive Action,and Barriers to Cardiovascular Disease Prevention by Race and Ethnicity in Women: An American Heart Association National Survey

Abstract

Background:

Racial and ethnic disparities in cardiovascular disease (CVD) outcomes and risk factors are well documented, but few data have evaluated population differences in CVD knowledge, preventive action, and barriers to prevention.

Methods:

A nationally representative sample of 1008 women (17% Hispanic, 22% black, 61% white/other) selected through random digit dialing were given a standardized questionnaire about knowledge of healthy risk factor levels, recent preventive actions, and barriers to prevention. Analysis focused on predictors of knowledge and preventive action in the past year and proportion reporting select barriers to prevention. Logistic regression was used to determine if race/ethnicity was independently associated with knowledge and preventive action after adjustment.

Results:

No racial/ethnic differences in risk factor knowledge were identified except Hispanic women were 44% less likely than white/others to know the optimal high-density lipoprotein cholesterol (HDL-C) level (odds ratio [OR] 0.56,95% confidence interval [CI] 0.35-0.91). Knowledge of blood pressure goal was lower among those with less than a college education (OR 0.59,95% CI 0.44-0.79). Hispanics were twice as likely as white/others to help someone else lose weight (OR 1.78,95% CI 1.17-2.71) or add physical activity (OR 1.95,95% CI 1.18-3.22) in the past year. Blacks were more likely than whites/others to report decreased unhealthy food consumption (OR 1.77,95% CI 1.08-2.93), trying to lose weight (OR 1.62,95% CI 1.06-2.47), and taking action when they experienced CVD symptoms (30% vs. 23%,p = 0.03). Physician encouragement was cited as the reason for taking preventive action more often by black (59%,p = 0.002) and Hispanic (54%,p = 0.03) women than whites/others (43%).

Conclusions:

Continued initiatives to improve and translate knowledge into preventive action are needed, especially among less educated and Hispanic women who may activate others to reduce risk.