Determinants of Cardiac Risk Factor Modification

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DESCRIPTION (provided by applicant): This career development program will foster the applicant's ability to become an independent investigator by providing didactic course work, structured mentorship, and hands-on research experience. The courses will focus on enhancing skills in research methodology, biostatistics, and grant writing. Structured weekly meetings with the mentor will focus on the progress of the study, publication of manuscripts, and submission of grants. The proposed prospective cohort study will apply constructs from the Transtheoretical Model to identify psychosocial determinants of participation in physical activity among Latino patients who have had coronary artery angioplasty. Specifically, the objectives are: 1) to determine whether more depressive symptoms is a predictor of participation in physical activity at two years and 2) to determine whether lower social support, lower self-efficacy, and greater perceived stress mediate the effects of depressive symptoms on physical activity. This study builds upon preliminary data from angioplasty patients supported by a Minority Investigator Research Supplement, which showed that at baseline only 18% of Latinos in this study were physically active. Latinos also had more depressive symptoms than non-Latinos and Latinos who had depressive symptoms were less likely to be physically active at 1 year. The proposed study builds upon previous work and enables the applicant to continue a research trajectory that focuses on identifying modifiable determinants of behavior change among minority populations with coronary artery disease. A total of 213 Latino patients who had angioplasty within one month of recruitment will complete standardized questionnaires assessing demographics, acculturation, cardiac risk factors, comorbidity, depressive symptoms measured by the Center for Epidemiologic Studies Depression Scale, social support, self-efficacy, and perceived stress. Follow-up interviews will occur every 6 months. The outcome measure is active participation in physical activity at a level of 30 minutes of moderate activity on at least 4 days of the week. Based on the stages of change construct of the Transtheoretical Model, participants who are in the action or maintenance stage of physical activity at this level will be classified as being active in physical activity. The long-term goal is to use this data to develop interventions that improve physical activity among Latino adults with coronary artery disease.