Southern rural black women's explanatory models of heart disease

Background/significance. Cardiovascular disease (CVD) kills more women than any other cause of death. However, black women are more likely than white women to underestimate their risk for CVD and less likely to participate in leisure-time physical activity (LTPA). Increasing LTPA can potentially decrease the risk for CVD. The purpose of this study was to explore black women's explanatory models (EMs) of the etiology, risk, and prevention of CVD.;Methods. An ethnographic design was used to explore EMs of CVD of 20 southern rural black women with at least 1 modifiable risk factor for CVD. Participants were recruited using convenience sampling at monthly staff meetings at a long-term care facility [n=14]. The other 6 participants were recruited through snowball sampling. Individual in-depth semi-structured audiotaped interviews were conducted primarily in women's homes. Descriptive statistics, content analysis, and constant comparison were used to analyze data.;Results. Participants were 40 to 58 years, and 19 of 20 were overweight. Other risk factors included: hypertension [n=14] and dyslipidemia [n=7]. Ten reported walking 1 to 2 times a week; only 3 reported LTPA at recommended levels. Although participants were queried about CVD, they focused solely on heart disease. Qualitative data revealed 3 factors of the "Causes of Heart Disease": (1) Lifestyle- "[E]atin' a lot of greasy food." (2) Physiologic Causes- "[P]eople that have diabetes will have heart problems." and (3) Going to Get It- "[A woman] can't prevent it if it's hereditary;" and 4 factors of women's "Thoughts about Physical Activity": (1) Thoughts about How Exercise Affects the Heart - "I would say it [exercise] wouldn't help them not to get it. I feel like it wouldn't be as bad." (2) Barriers to Exercise- "I just don't have the energy to exercise." (3) Reasons to Exercise - "It's a stress reliever for me to be able to walk." and (4) Taking Action- "I don't do it [exercise] as often as I should.";Discussion. Misconceptions regarding the inevitability of CVD, incongruous thoughts about the role of LTPA, and lack of personalization of CVD risk indicate that further education is needed, as is the development of interventions to assist women to increase LTPA.