Risk Perception and its Association with Cardiac Risk and Health Behaviors among Urban Minority Adults: The Bronx Coronary Risk Perception Study

Abstract

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.

Factors Associated with Blue-collar Workers' Risk Perception of Cardiovascular Disease

“…Blue-collar workers in the high CVD risk group perceived they were vulnerable and susceptible to CVD. Several studies that incorporated actual risk and perceived risk (Barnhart et al, 2009;Christian et al, 2005;Frijling et al, 2004;Homko et al, 2008) were identified. Of these, three studies used the Framing- showed an association between CVD risk and CVD risk perception.…”

Risk perception of cardiovascular diseases among individuals with hypertension in rural Malaysia

“…It is helpful in the risk dialogue or during patient consultation or counselling 2. Knowing patients’ concerns and how patients perceive their risk are important initial steps in appropriately managing the risk 3 4.…”

Public Reporting in Cardiovascular Medicine

“…61 However, patient perception of actual risk often differs from modelpredicted risk. [62][63][64] If clinician-perceived risk also differs from model-predicted risk, the potential for systematic distortion in patient selection exists. Our hope is that clinicians' benevolence and fiduciary responsibilities toward patients drive them to always consider an individual patient's best interest.…”