PURPOSE To examine the relationship between risk perceptions, health behaviors, and a measure for actual risk of coronary heart disease (CHD). DESIGN Cross-sectional survey. SETTING/SUBJECTS Adults from three outpatient medical clinics with at least one CHD risk factor. MEASURES Perceived risk using the new Coronary Risk, Individual Perception (CRIP) scale, an index of CHD risk, and summary scores for self-reported diet and exercise. ANALYSIS Bivariate associations using Spearman Rank and Kruskil-Wallis; multiple regression models for outcomes (health behaviors). RESULTS The 16-item CRIP scale had acceptable internal consistency (α =0.76; inter-item total correlation=0.34 ± 0.17). The response rate was 80.3% and the mean age of 256 respondents was 56.6 (±9.9) years; 70% were women, 63% Hispanic, and 27% black. CRIP scores were inversely associated with low-fat/high fiber intake (r=− 0.17; p=0.007) and exercise (r=−0.19; p=0.003). Among respondents with 3 or more CHD risk factors (n=132), 44% perceived themselves to be at low risk for CHD. In multivariable models, men with high CRIP scores had higher fat intake than women (p=0.02), but men exercised more (p=0.04). CONCLUSIONS In this study, gender moderated the relationship between risk perception and health behaviors and many respondents underestimated their risk of CHD. Behavioral research aimed at reducing cardiometabolic risk in minority populations should resolve differences between perceived and actual risk of CHD to foster lifestyle changes, and examine temporal relationships between risk perception and health behaviors.

Racial/ethnic and sex disparities in coronary heart disease treatment exist. We previously reported that physicians perceive non-clinical variables, such as a patient's desire for a second opinion, as affecting revascularization decisions. The results of that study are further examined here, using factor analysis to identify significant interrelationships among the non-clinical variables, which could contribute to disparities in coronary revascularization (i.e., percutaneous transluminal coronary angioplasty [PTCA] or coronary artery bypass graft [CABG]). Five content themes emerged using factor analysis; these are related to the patient's socioeconomic/lifestyle status, treatment preference, physician interaction, health-assertiveness, and aggressiveness. For the lifestyle theme, family physicians had higher mean scores (14.8) than internists, cardiologists, and cardiothoracic surgeons (13.7, 13.6, and 12.6, respectively; overall p=.001); women had higher mean scores than men (15.0 vs. 13.7; p=.009). This implies that family medicine and female physicians perceived variables pertaining to patients' socioeconomic status or lifestyle (e.g., financial barriers, unlikely to adopt healthy behaviors) as precluding some patients from being revascularized. Additionally, female, more than male, physicians (15.0 vs.13.6; p=.006) perceived health assertive patients (e.g., involved in treatment decisions, will quit smoking) as having easier access to the procedures. The results of the present analysis suggest that disparities in cardiac care arise from complex psychosocial interactions, which are influenced by characteristics of the physician as well as the patient.

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Background Recent national estimates found that 37.2% of school aged children (6-11 years old) have a Body Mass Index (BMI) greater than the 85 th percentile for age and sex, and 18.8% of children have a BMI greater than the 95 th BMI percentile. 1 In New York City, these percentages are even higher, with 43% greater than the 85 th percentile and 19% greater than the 95 th percentile for BMI. 2 Mexican American and Non-Hispanic black children are more likely to fall into these categories than Non-Hispanic white children. 1 Interventions to promote healthy weight behaviors among children are greatly needed. Preventive health interventions such as observational learning and modeling can bring about a change in children's thought processes and behaviors. 3 Puppets are an imaginative and fun way of providing health information according to social cognitive and norming principles. Puppets have been used to educate children on a variety of topics such as HIV, first aid, hygiene, and fruit and vegetable intake. 4 The goal of this puppet show was to generate enthusiasm and promote dialogue about diet and physical activity.