Increasing accuracy of risk perceptions and knowledge of myocardial infarction symptoms among older, Black and White high-risk women

Coronary heart disease (CHD) is the single largest killer of American women and the death toll rises dramatically with age. Myocardial infarction (MI), resulting from CHD, is disproportionately prevalent among older women, especially African Americans. However, many older women are unaware of this and do not perceive MI as a personal health risk. Additionally, women lack knowledge about their common MI symptoms and do not recognize them or attribute them to a cardiac etiology when symptoms occur. Purposes. Using the Health Belief Model as the conceptual framework, a pretest-posttest quasi-experimental study aimed to determine if a tailored educational/counseling intervention presented to older, African American and Caucasian community-dwelling women at high-risk for MI would improve self-identification of risk factors, the accuracy of their perceived risk for MI, and increase their knowledge of women's MI symptoms. Method. Using faith-based recruitment techniques, the author recruited 96 older (≥ 60 years of age), African American (n=48) and Caucasian (n=48) high-risk women from 7 churches in central Arkansas. Each church was randomized into control and intervention groups, stratified by race. Pretest and posttest measures assessing risk factor knowledge, personal perceived risk, and symptom knowledge were administered. Results. African American women were statistically (p<0.05) more often smokers, non-exercisers, did not follow heart-smart diets, had more obesity, and were more economically and educationally disadvantaged when compared to Caucasian women. All racially diverse women clearly underestimated their defined risks for CHD (p<.001). Post-intervention, analysis of covariance demonstrated the educational/counseling intervention successfully improved risk identification (p=.004) and accuracy of personal risk beliefs (p<.001) with little change in the control group at 1 month. The intervention was also successful in improving knowledge of MI symptoms (p<.001). Interaction effects of race and intervention were absent as both racial groups improved similarly. Discussion. This study supports that tailored educational interventions for high-risk, older Black and White women can increase accuracy of risk identification, perceptions, and knowledge of CHD symptoms. Future studies are needed that include outcome measures of medical treatment-seeking time intervals and mortality and morbidity related to tailored risk and knowledge interventions.