Predictors of Cardiovascular Health Promotion

Coronary heart disease (CHD) is the leading cause of death and disability in the United States (US), and underrepresented racial-ethnic groups experience cardiovascular health disparities in access to care, preventive services, and medical treatments. In Mexican-Americans, the burden of CHD is equal, if not greater than that of non-Hispanic whites. A health-promoting lifestyle can largely reduce cardiovascular risk and/or delay disease progression. Hence, the purpose of this study is to identify predictors associated with cardiovascular health-promoting lifestyle behaviors in Mexican-American women. A descriptive cross-sectional study design targeted Mexican-American women residing in the Philadelphia area. A sample of 128 women, at least 18 years old and free of CHD, was enrolled. Analyses consisted of correlations and multiple linear regressions to determine the influence between knowledge of CHD and associated risk factors, perceived health status, acculturation level, and menopausal status on cardiovascular health promotion. Spanish surveys were used for data collection. A mild positive correlation was found between perceived health status and cardiovascular health-promoting lifestyles (r=.495, p=.001) and also with knowledge levels of CHD and risk (r=.305, p=.001). In adjusted models, cardiovascular health promotion was only associated with perceived health status (b=.112, 95% CI=.058-.165, p<.001). Demographic variables that also supported heart-healthy lifestyles were: increased age (b=.009, p =.050); post college versus less than five years of formal schooling (b=-.327, p=.038); and needing reading assistance (b=-.373, p=0.002). Study findings reveal a relatively young sample of Mexican-American women who preferred to speak Spanish, regardless of birth country, length of US residency, or acculturation level. These women perceived they could influence the present, when it becomes necessary, but maintained a positive health outlook. Study findings thus broaden existing knowledge of cardiovascular health promotion in underserved ethnic populations and add depth to the prevailing health disparity paradigm that affects Hispanic healthcare in the US today. Enhanced understanding fosters future development of sex-specific and culturally-sensitive strategies to promote heart-healthy lifestyles and effectively eliminate health disparities in this growing cohort of women. Degree Type Dissertation Degree Name Doctor of Philosophy (PhD) Graduate Group Nursing First Advisor Kathleen McCauley, PhD, RN, ACNS-BC, FAAN, FAHA Second Advisor Anne Keane, EdD, RN, CRNP, FAAN This dissertation is available at ScholarlyCommons: http://repository.upenn.edu/edissertations/200 Third Advisor Norma G. Cuellar, DSN, RN