Barriers to Cardiovascular Disease Preventive Behaviors Among OEF/OIF/OND Women and Men Veterans
Barriers to Cardiovascular Disease Preventive Behaviors Among OEF/OIF/OND Women and Men Veterans
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DOI：
10.1037/hea0000844
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发表时间：
2020-04-01
影响因子：
4.2
通讯作者：
Burg, Matthew M.
中科院分区：
文献类型：
--
作者：
Cavanagh, Casey E.;Rosman, Lindsey;Burg, Matthew M.
目的：OEF/OIF/OND退伍军人患心血管疾病(CVD)的风险较高，但研究表明，即使在高危人群中，参与心血管疾病预防行为的比例也很低。重要的是要了解退伍军人参与预防工作的障碍，以便制定有针对性的干预措施，解决障碍和减少心血管疾病的发病率。方法：女性退伍军人队列研究调查了OEF/OIF/OND退伍军人(586名女性和555名男性)，评估了患者、人际和系统层面的心血管风险预防障碍。确定障碍的流行程度，并进行卡方检验性别差异。进行多因素Logistic回归分析，以确定在调整人口统计学因素(年龄、婚姻状况、教育程度、就业状况)时，性别差异是否仍然存在。结果：尽管应答率很低(11.5%)，但男性和女性对障碍的认可程度都很高，大多数人(56.8%)并不认为自己有心血管疾病的风险。更多的男性倾向于不改变生活方式(40.9%比29.1%)。更多的女性支持缺乏自信(42.4%比36.1%)、压力(36.9%比27.8%)、抑郁(36.9%比27.8%)、社会支持不足(26%比20.9%)，以及认为她们的临床医生不认为她们有风险(57.8%比32%)，也没有解释心血管疾病预防行为(19%比12.3%)。多变量分析降低了性别差异的统计学意义。结论：鉴于应答率低，需要测试努力--例如，实施科学方法--以评估这一人群中降低心血管疾病风险的障碍，这是退伍军人健康管理局非常适合的任务。
Objective: OEF/OIF/OND Veterans have an elevated risk for developing cardiovascular disease (CVD), but research suggests that engagement in CVD preventive behaviors is low even among at-risk individuals. It is critical to understand barriers to prevention engagement among Veterans to inform the development of tailored interventions addressing barriers and reducing CVD incidence. Method: The Women Veterans Cohort Study survey of OEF/OIF/OND Veterans (586 women and 555 men) assessed patient, interpersonal, and systems level barriers to CVD risk prevention. Prevalence of barriers was determined, and chi-squares were conducted to examine sex differences. Multivariate logistic regressions were conducted to determine if sex differences remained when adjusting for demographic factors (age, marital status, education, employment status). Results: Despite a low response rate (11.5%), endorsement of barriers was high for both women and men, with most (56.8%) not perceiving themselves to be at CVD risk. More men preferred making no lifestyle change (40.9% vs. 29.1%). More women endorsed lack of confidence (42.4% vs. 36.1%), stress (36.9% vs. 27.8%) and depression (36.9% vs. 27.8%), and inadequate social support (26% vs. 20.9%), along with the belief that their clinician does not perceive them as at risk (57.8% vs. 32%) and has not explained CVD preventive behaviors (19% vs. 12.3%). Multivariate analyses reduced statistical significance of sex differences. Conclusions: Given the low response rate, testing of efforts-for example, implementation science methods-to assess CVD risk reduction barriers in this population are needed, a task for which the Veterans Health Administration is well suited.