Other Titles

Cardiovascular Awareness, Cardiovascular Risk Factors Awareness, and Select Risk Reduction Interventions [Title Slide]

Abstract

Cardiovascular disease (CVD) remains the leading cause of death globally, with African American (AA) females experiencing a disproportionately higher burden of CVD compared to other racial and gender-ethnic groups. This disparity is particularly pronounced among premenopausal and middle-aged AA females. While CVD is primarily preventable, addressing social determinants of health (SDoH) and achieving equitable health requires a comprehensive understanding of the factors influencing CVD risk and health behaviors.

This descriptive correlational study employed a secondary data analysis using the 2020 National Health Interview Survey (NHIS) datasets to examine the relationships among CVD awareness, modifiable risk factor awareness, clinician cues to action, and preventative lifestyle behaviors among middle-aged AA women (n=962, ages 35-64), and the role of education as a moderator of CVD risk factors and healthy lifestyle behavior. Preventative lifestyle behaviors were defined either as healthy lifestyle behaviors (physical activity and BMI <30) or lifestyle behavior modification (increasing exercise, reducing fat/calories, participating in a weight loss program). Logistic regression analyses simultaneously controlled for SDOH: food/economic security, social support, healthcare access, neighborhood, and education. Sub-analyses explored relationships between favorable SDOH and physical activity and between clinician cues to action and lifestyle behavior modification for obese and non-physically active females.

Results revealed relationships between CVD awareness, CVD modifiable risk factor awareness, clinician cues to action, and the adoption of preventative lifestyle behaviors but failed to observe a moderating effect of education on the relationship between CVD risk factor awareness and healthy lifestyle behaviors. Favorable SDOH was associated with active engagement in physical activity.

This study underscores the complex relationship of factors influencing CVD preventative behaviors and demonstrates that awareness of CVD and risk factors alone may not be sufficient to promote behavior change. The critical role of clinician influence to promote lifestyle behavior modifications among this high-risk population is highlighted. Together, these findings suggest the need for tailored interventions that address both individual and social factors to improve CVD outcomes in middle-aged AA females.

Notes

References:

1. Acquah, I., Hagan, K., Javed, Z., Taha, M. B., Valero-Elizondo, J., Nwana, N., Yahya, T., Sharma, G., Gulati, M., Hammoud, A., Shapiro, M. D., Blankstein, R., Blaha, M. J., Cainzos-Achirica, M., & Nasir, K. (2023). Social Determinants of Cardiovascular Risk, Subclinical Cardiovascular Disease, and Cardiovascular Events. Journal of the American Heart Association, 12(6), e025581. https://doi.org/10.1161/JAHA.122.025581

2. Cho, L., Davis, M., Elgendy, I., Epps, K., Lindley, K. J., Mehta, P. K., Michos, E. D., Minissian, M., Pepine, C., Vaccarino, V., Volgman, A. S., & ACC CVD Womens Committee Members (2020). Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 75(20), 2602–2618. https://doi.org/10.1016/j.jacc.2020.03.060

3. Cushman, M., Shay, C. M., Howard, V. J., Jiménez, M. C., Lewey, J., McSweeney, J. C., ... & American Heart Association. (2021). Ten-year differences in women’s awareness related to coronary heart disease: results of the 2019 American Heart Association National Survey: a special report from the American Heart Association. Circulation, 143(7), e239-e248. doi:10.1161/CIR.0000000000000907

4. Lindley, K. J., Aggarwal, N. R., Briller, J. E., Davis, M. B., Douglass, P., Epps, K. C., ... & American College of Cardiology Cardiovascular Disease in Women Committee and the American College of Cardiology Health Equity Taskforce. (2021). Socioeconomic determinants of health and cardiovascular outcomes in women: JACC review topic of the week. Journal of the American College of Cardiology, 78(19), 1919-1929.

5. Mangione, C. M., Barry, M. J., Nicholson, W. K., Cabana, M., Coker, T. R., Davidson, K. W., ... & US Preventive Services Task Force. (2022). Behavioral counseling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults without cardiovascular disease risk factors: US preventive services task force recommendation statement. Jama, 328(4), 367-374.

6. Ogunniyi, M. O., Mahmoud, Z., Commodore-Mensah, Y., Fleg, J. L., Fatade, Y. A., Quesada, O., Aggarwal, N. R., Mattina, D. J., Moraes De Oliveira, G. M., Lindley, K. J., Ovbiagele, B., Roswell, R. O., Douglass, P. L., Itchhaporia, D., Hayes, S. N., & American College of Cardiology Cardiovascular Disease in Women Committee and the American College of Cardiology Health Equity Taskforce (2022). Eliminating Disparities in Cardiovascular Disease for Black Women: JACC Review Topic of the Week. Journal of the American College of Cardiology, 80(18), 1762–1771. https://doi.org/10.1016/j.jacc.2022.08.769

7. Shah, N. S., Ning, H., Petito, L. C., Kershaw, K. N., Bancks, M. P., Reis, J. P., ... & Khan, S. S. (2022). Associations of clinical and social risk factors with racial differences in premature cardiovascular disease. Circulation, 146(3), 201-210. https://doi.org/10.1161/CIRCULATIONAHA.121.058311

8. Xia M, An J, Safford MM, Colantonio LD, Sims M, Reynolds K, Moran AE, Zhang Y. Cardiovascular Risk Associated With Social Determinants of Health at Individual and Area Levels. JAMA Netw Open. 2024 Apr 1;7(4):e248584. doi: 10.1001/jamanetworkopen.2024.8584. PMID: 38669015; PMCID: PMC11053380.

Description

Cardiovascular disease (CVD) is the leading cause of death with African American (AA) females experiencing a disproportionately higher burden of CVD. This study examined the relationships among CVD awareness, modifiable risk factor awareness, clinician cues to action, and preventative lifestyle behaviors, and the role of education as a moderator of CVD risk factors and healthy lifestyle behavior. Awareness of CVD and risk factors alone may not be sufficient to promote behavior change.

Author Details

Kimberly A. Henderson, PhD, DNP, CRNP-BC

Sigma Membership

Eta

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Descriptive/Correlational

Research Approach

Quantitative Research

Keywords:

Health Equity or Social Determinants of Health, Primary Care, Cardiovascular Disease, Cardiovascular Disease Risk Factors, African American Females

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Cardiovascular Awareness, Risk Factors Awareness, and Select Risk Reduction Interventions

Seattle, Washington, USA

Cardiovascular disease (CVD) remains the leading cause of death globally, with African American (AA) females experiencing a disproportionately higher burden of CVD compared to other racial and gender-ethnic groups. This disparity is particularly pronounced among premenopausal and middle-aged AA females. While CVD is primarily preventable, addressing social determinants of health (SDoH) and achieving equitable health requires a comprehensive understanding of the factors influencing CVD risk and health behaviors.

This descriptive correlational study employed a secondary data analysis using the 2020 National Health Interview Survey (NHIS) datasets to examine the relationships among CVD awareness, modifiable risk factor awareness, clinician cues to action, and preventative lifestyle behaviors among middle-aged AA women (n=962, ages 35-64), and the role of education as a moderator of CVD risk factors and healthy lifestyle behavior. Preventative lifestyle behaviors were defined either as healthy lifestyle behaviors (physical activity and BMI <30) or lifestyle behavior modification (increasing exercise, reducing fat/calories, participating in a weight loss program). Logistic regression analyses simultaneously controlled for SDOH: food/economic security, social support, healthcare access, neighborhood, and education. Sub-analyses explored relationships between favorable SDOH and physical activity and between clinician cues to action and lifestyle behavior modification for obese and non-physically active females.

Results revealed relationships between CVD awareness, CVD modifiable risk factor awareness, clinician cues to action, and the adoption of preventative lifestyle behaviors but failed to observe a moderating effect of education on the relationship between CVD risk factor awareness and healthy lifestyle behaviors. Favorable SDOH was associated with active engagement in physical activity.

This study underscores the complex relationship of factors influencing CVD preventative behaviors and demonstrates that awareness of CVD and risk factors alone may not be sufficient to promote behavior change. The critical role of clinician influence to promote lifestyle behavior modifications among this high-risk population is highlighted. Together, these findings suggest the need for tailored interventions that address both individual and social factors to improve CVD outcomes in middle-aged AA females.