Abstract 3093: CVD Knowledge, Self-Efficacy and Risk Perceptions among Disadvantaged Populations
Cardiovascular disease (CVD) risk reduction has a strong behavioral component, which emphasizes the adoption of healthy life-style behaviors. Disparities in CVD rates have been noted by race/ethnicity, socioeconomic status and geography. This study examined knowledge of CVD risk factors, self-efficacy, and risk perception among underserved patients at increased risk for CVD (10% or greater CVD risk on the Framingham risk index). The sample consisted of inner city and rural underserved patients (43% <$25,000 annual family income) enrolled in a telemedicine trial to reduce CVD risk. Knowledge of CVD risk factors, perception of CVD risk, medication, exercise, and nutrition self-efficacy were assessed. The average age of subjects (N=461) was 60.5± 10.1 years and their mean CVD risk score was 17.0 ± 9.8. %. Fifty-five percent of participants (N=254) were from rural areas and 45% (N=207) were from the inner city. Urban participants were younger (58.2 ±10.1 vs 62.6 ± 9.6 years; p=0.001) but had a higher CVD risk (18.3 ±10.7% vs 16.0 ± 8.9%; p=0.01) than did rural participants. Rural subjects scored significantly higher on the knowledge survey (70% ±13%verus 56% ± 13%; p < 0.001), which was consistent across all content areas. Despite their actual increased CVD risk, inner city participants rated their risk to be significantly lower than rural counterparts (0.18 ± 1.4 versus 0.50 ± 1.3; p=0.01). Urban participants scored significantly lower in regards to exercise self-efficacy (2.5 ± 0.9 versus 2.9 ± 0.8; p <0.01) and medication adherence (2.56 ± 0.44 versus 2.74 ± 0.31; p <0.01). Nutrition self-efficacy did not differ between groups however inner city participants demonstrated a significantly greater intent to adopt prevention nutrition habits (3.04 ± 0.61 versus 2.90 ± 0.62; p <0.02). In summary, underserved inner city participants demonstrate CVD knowledge deficits, low self-efficacy and reduced CVD risk perceptions all of which are considered important determinants of behavior change. These data suggest that public health campaigns to increase CVD risk awareness are missing the most disadvantaged members of our society.