Mudd-Martin Gia, Rayens Mary Kay, Lennie Terry A, Chung Misook L, Gokun Yevgeniya, Wiggins Amanda T, Biddle Martha J, Bailey Alison L, Novak M J, Casey Baretta R, Moser Debra K
College of Nursing, University of Kentucky, Lexington, Kentucky.
J Rural Health. 2015 Spring;31(2):206-16. doi: 10.1111/jrh.12094. Epub 2014 Sep 22.
In rural communities that experience high rates of cardiovascular disease (CVD) morbidity and mortality, family history education may enhance risk awareness and support engagement in healthy behaviors but could also engender fatalism. This study was conducted to assess if the relationship between family history and adherence to healthy lifestyle behaviors is moderated by fatalism.
Baseline data were obtained from 1,027 adult participants in the HeartHealth in Rural Kentucky study. Multiple linear regression was used to determine whether fatalism moderated the relationship between high-risk family history of CVD and adherence to healthy lifestyle behaviors, controlling for sociodemographic variables and CVD risk factors. The relationship between family history and healthy behaviors was assessed for subgroups of participants divided according to the upper and lower quartiles of fatalism score.
The relationship between high-risk family history of CVD and adherence to healthy behaviors was moderated by fatalism. Among those with the highest quartile of fatalism scores, high-risk family history predicted greater adherence to healthy behaviors, while among those in the lowest quartile, and among those with the middle 50% of fatalism scores, there was no association between family history and healthy behavior scores.
Family history education can provide people at increased risk for CVD important information to guide health practices. This may be particularly relevant for those with a high degree of fatalistic thinking. In rural communities with limited health resources, family history education, combined with assessment of fatalism, may support better targeted interventions to enhance engagement in healthy behaviors.
在心血管疾病（CVD）发病率和死亡率较高的农村社区，家族史教育可能会提高风险意识并支持人们参与健康行为，但也可能导致宿命论。本研究旨在评估宿命论是否会调节家族史与坚持健康生活方式行为之间的关系。
从肯塔基州农村地区心脏健康研究的1027名成年参与者中获取基线数据。使用多元线性回归来确定宿命论是否调节了CVD高危家族史与坚持健康生活方式行为之间的关系，并控制社会人口统计学变量和CVD风险因素。根据宿命论得分的上四分位数和下四分位数对参与者进行分组，评估家族史与健康行为之间的关系。
宿命论调节了CVD高危家族史与坚持健康行为之间的关系。在宿命论得分最高的四分位数人群中，高危家族史预示着更坚持健康行为，而在得分最低的四分位数人群以及宿命论得分处于中间50%的人群中，家族史与健康行为得分之间没有关联。
家族史教育可以为CVD风险增加的人群提供重要信息，以指导健康实践。这对于那些宿命论思维程度较高的人可能尤为重要。在健康资源有限的农村社区，家族史教育与宿命论评估相结合，可能有助于更有针对性地进行干预，以促进人们参与健康行为。
