School of Social and Behavioral Sciences, Stockton University, 101 Vera King Farris Drive, Galloway, NJ, 08205, USA.
Atlanticare Health Services, 1401 Atlantic Ave, Atlantic City, NJ, 08401, USA.
BMC Public Health. 2021 Mar 15;21(1):504. doi: 10.1186/s12889-021-10423-6.
Poverty increases the risk of cardiac disease, while diminishing the resources available to mitigate that risk. Available prevention programs often require resources that low-income residents of urban areas do not possess, e.g. membership fees, resources to purchase healthy foods, and safe places for physical activity. The aim of this study is to obtain participant input in order to understand the health-related goals, barriers, and strengths as part of planning a program to reduce cardiovascular risk.
In a mixed methods study, we used written surveys and focus groups as part of planning an intervention specifically designed to meet the needs of lower income individuals. Based on prior research, we used Self-Determination Theory (SDT) and its core constructs of autonomy, competence, and relatedness as the theoretical framework for analysis. The study collected information on the perspectives of low-income urban residents on their risks of cardiovascular disease, their barriers to and supports for addressing health needs, and how they addressed barriers and utilized supports. Focus group transcripts were analyzed using standard qualitative methods including paired coding and development of themes from identified codes.
Participants had health goals that aligned with accepted approaches to reducing their cardiovascular risks, however they lacked the resources to reach those goals. We found a lack of support for the three SDT core constructs. The barriers that participants reported suggested that these basic psychological needs were often thwarted by their environments.
Substantial disparities in both access to health-promoting resources and in support for autonomy, competence, and relatedness must be addressed in order to design an effective intervention for a low-income population at cardiac risk.
贫困增加了患心脏病的风险，同时也减少了减轻这种风险的可用资源。现有的预防计划通常需要城市低收入居民所不具备的资源，例如会员费、购买健康食品的资源以及进行体育活动的安全场所。本研究的目的是获得参与者的投入，以便了解健康相关的目标、障碍和优势，作为制定降低心血管风险计划的一部分。
在一项混合方法研究中，我们使用书面调查和焦点小组作为专门为满足低收入个人需求而设计的干预措施的一部分。基于先前的研究，我们使用自我决定理论（SDT）及其自主性、能力和关联性的核心结构作为分析的理论框架。该研究收集了有关低收入城市居民对心血管疾病风险的看法、他们解决健康需求的障碍和支持，以及他们如何解决障碍和利用支持的信息。焦点小组的转录本使用标准的定性方法进行分析，包括配对编码和从已识别的代码中开发主题。
参与者有与降低心血管风险的公认方法一致的健康目标，但他们缺乏实现这些目标的资源。我们发现缺乏对 SDT 三个核心结构的支持。参与者报告的障碍表明，这些基本的心理需求经常受到环境的阻碍。
为了为处于心脏病风险的低收入人群设计有效的干预措施，必须解决在获得促进健康的资源以及在自主性、能力和关联性方面的支持方面存在的巨大差距。
