Abstract 13813: High Levels of Cardiometabolic Risk, Knowledge, and Risk Perception Co-Occur with Low Self-Efficacy to Prevent Cardiometabolic Disease in American Indian Women with Previous Gestational Diabetes
Background: Knowledge of risk factors, risk perception, and self-efficacy are central to preventing cardiometabolic disease (CMD) among women with previous gestational diabetes mellitus (GDM). Although the incidence of CVD in American Indians is twice that of the general U.S. population, partially attributed to type 2 diabetes (T2D), little is known about American Indian women's (AIW) knowledge, risk perception, and self-efficacy to prevent these diseases following GDM.
Objective: Examine the prevalence of cardiometabolic risk and describe AIW's knowledge, risk perception for T2D and CVD, and self-efficacy beliefs related to disease prevention.
Methods: A cross-sectional, descriptive mixed methods study was conducted with 22 self-identified AIW (36.59 ± 5.8 years; documented history of GDM) recruited from a tribal health system in a Southwestern state. Risk was measured using harmonized MetS criteria and HOMA-IR. Knowledge, risk perception, and self-efficacy were measured using a modified Risk Perception Survey for Developing Diabetes (adapted from DPP) and a modified Heart Disease Fact Questionnaire. In-depth interviews allowed for rich description of risk perception and self-efficacy. Interview data were content analyzed; two researchers independently coded data, validated the coding scheme, and resolved discrepancies in formulation of categories and central theme.
Results: The majority of AIW (n = 13, 62%) were classified as having MetS; 13 of 18 (72%) were insulin resistant (HOMA-IR > 2.7; 6.38 ± 5.74). Mixed methods data indicated high levels of knowledge and risk perception related to T2D and CVD, but low self-efficacy related to preventing CMD. The central theme, lack of motivation and trying to become motivated, comprised four categories that offered further insight into risk perceptions and self-efficacy beliefs: concerns, control, beliefs/attitudes, and views about prevention.
Conclusion: High levels of cardiometabolic risk, knowledge, and risk perception co-occur with low self-efficacy to prevent CMD in AIW with previous GDM. Findings indicate the need to further explore AIW's self-efficacy beliefs in a cultural context prior to developing effective self-efficacy enhancing interventions designed to prevent T2D and CVD.
- © 2011 by American Heart Association, Inc.