Reges Orna, Vilchinsky Noa, Leibowitz Morton, Khaskia Abdulrahem, Mosseri Morris, Kark Jeremy D
Hebrew University and Hadassah Medical Center, Jerusalem, Israel Clalit Research Institute, Tel-Aviv, Israel Meir Medical Center, Kfar-Saba, Israel
Bar-Ilan University, Ramat-Gan, Israel.
Eur J Prev Cardiol. 2015 Apr;22(4):458-67. doi: 10.1177/2047487314520924. Epub 2014 Jan 27.
Health-promoting behaviours after acute coronary syndrome (ACS) are effective in preventing recurrence. Ethnicity impacts on such behaviours. We assessed the independent association of Arab vs. Jewish ethnicity with persistence of smoking and physical inactivity 6 months after ACS in central Israel.
Prospective cohort study.
During their admission for ACS and subsequently 6 months later, 420 patients were interviewed about their smoking and exercise habits. The association of ethnicity with health-promoting behaviours was assessed by logistic regression adjusting for socio-demographic and clinical covariates.
Smoking prevalence and physical inactivity were substantially higher among Arab patients than Jewish patients at admission (gender-adjusted prevalence rate ratio (RR) 2.25, 95% CI 1.80-2.81, p < 0.01 and RR 1.46, 95% CI 1.28-1.67, p < 0.001, respectively). The relative differences increased at 6 months (RR 2.94, 95% CI 2.13-4.07, p < 0.001 and RR 3.00, 95% CI 2.24-4.04, p < 0.001, respectively). Excess persistent smoking at 6 months among Arab vs. Jewish patients who were smokers at admission (adjusted OR 2.05, 95% CI 1.00-4.20, p = 0.049) was largely mediated through the 3.5-fold higher participation of Jewish patients in cardiac prevention and rehabilitation program (CPRP) (OR adjusted also for CPRP 1.31, 95% CI 0.59-2.93, p = 0.51). Greater persistent sedentary behaviour at 6 months among nonexercisers at admission among Arab patients (adjusted OR 3.68, 95% CI 1.93-7.02, p < 0.001) was partly mediated through attendance of CPRP (OR adjusted also for CPRP 2.38, 95% CI 1.19-4.76, p = 0.014).
Culturally sensitive programmes need to be developed to enhance CPRP participation and favourable health-promoting changes among Arab patients. A comprehensive understanding of the determinants of the Arab-Jewish differences in efficacious health-promoting behaviours is crucial to inform appropriate ethnic-specific health-promoting strategies.
急性冠状动脉综合征（ACS）后的健康促进行为对预防复发有效。种族会影响此类行为。我们评估了以色列中部阿拉伯人与犹太人种族与ACS后6个月持续吸烟和缺乏身体活动之间的独立关联。
前瞻性队列研究。
在420例患者因ACS入院期间及随后6个月时，对他们的吸烟和运动习惯进行了访谈。通过对社会人口统计学和临床协变量进行调整的逻辑回归分析，评估种族与健康促进行为之间的关联。
入院时，阿拉伯患者的吸烟率和缺乏身体活动的比例显著高于犹太患者（性别调整后的患病率比值（RR）为2.25，95%置信区间为1.80 - 2.81，p < 0.01；RR为1.46，95%置信区间为1.28 - 1.67，p < 0.001）。6个月时相对差异增大（RR分别为2.94，95%置信区间为2.13 - 4.07，p < 0.001；RR为3.00，95%置信区间为2.24 - 4.04，p < 0.001）。入院时吸烟的阿拉伯患者与犹太患者相比，6个月时持续吸烟过量（调整后的OR为2.05，95%置信区间为1.00 - 4.20，p = 0.049）很大程度上是通过犹太患者参与心脏预防和康复项目（CPRP）的比例高出3.5倍来介导的（调整后的OR也考虑了CPRP为1.31，95%置信区间为0.59 - 2.93，p = 0.51）。入院时不运动的阿拉伯患者中，6个月时持续久坐行为更严重（调整后的OR为3.68，95%置信区间为1.93 - 7.02，p < 0.001）部分是通过参与CPRP来介导的（调整后的OR也考虑了CPRP为2.38，95%置信区间为1.19 - 4.76，p = 0.014）。
需要制定具有文化敏感性的项目，以提高阿拉伯患者对CPRP的参与度以及促进有利的健康促进变化。全面了解阿拉伯 - 犹太在有效健康促进行为方面差异的决定因素，对于制定适当的针对特定种族的健康促进策略至关重要。
