Bradley Kolbi, Arconada Alvarez Santiago J, Gilmore Amanda K, Greenleaf Morgan, Herbert Aayahna, Kottke Melissa J, Parsell Maren, Patterson Sierra, Smith Tymirra, Sotos-Prieto Mercedes, Zeichner Elizabeth, Gooding Holly C
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States.
Georgia Clinical and Translational Science Alliance, Atlanta, GA, United States.
JMIR Form Res. 2022 Dec 19;6(12):e42051. doi: 10.2196/42051.
Cardiovascular disease (CVD) is the leading cause of death among women in the United States. A considerable number of young women already have risk factors for CVD. Awareness of CVD and its risk factors is critical to preventing CVD, yet younger women are less aware of CVD prevalence, its risk factors, and preventative behaviors compared to older women.
The purpose of this study is to assess CVD awareness among adolescent and young adult women and develop a lifestyle-based cardiovascular risk assessment tool for the promotion of CVD awareness among this population.
This study used a 3-phase iterative design process with young women and health care practitioners from primary care and reproductive care clinics in Atlanta, Georgia. In phase 1, we administered a modified version of the American Heart Association Women's Health Survey to young women, aged 15-24 years (n=67), to assess their general CVD awareness. In phase 2, we interviewed young women, aged 13-21 years (n=10), and their health care practitioners (n=10), to solicit suggestions for adapting the Healthy Heart Score, an existing adult cardiovascular risk assessment tool, for use with this age group. We also aimed to learn more about the barriers and challenges to health behavior change within this population and the clinical practices that serve them. In phase 3, we used the findings from the first 2 phases to create a prototype of a new online cardiovascular risk assessment tool designed specifically for young women. We then used an iterative user-centered design process to collect feedback from approximately 105 young women, aged 13-21 years, as we adapted the tool.
Only 10.5% (7/67) of the young women surveyed correctly identified CVD as the leading cause of death among women in the United States. Few respondents reported having discussed their personal risk (4/67, 6%) or family history of CVD (8/67, 11.9%) with a health care provider. During the interviews, young women reported better CVD awareness and knowledge after completing the adult risk assessment tool and suggested making the tool more teen-friendly by incorporating relevant foods and activity options. Health care practitioners emphasized shortening the assessment for easier use within practice and discussed other barriers adolescents may face in adopting heart-healthy behaviors. The result of the iterative design process was a youth-friendly prototype of a cardiovascular risk assessment tool.
Adolescent and young adult women demonstrate low awareness of CVD. This study illustrates the potential value of a cardiovascular risk assessment tool adapted for use with young women and showcases the importance of user-centered design when creating digital health interventions.
心血管疾病（CVD）是美国女性的首要死因。相当数量的年轻女性已经存在心血管疾病的风险因素。了解心血管疾病及其风险因素对于预防心血管疾病至关重要，然而与年长女性相比，年轻女性对心血管疾病的患病率、风险因素及预防行为的知晓度较低。
本研究旨在评估青少年及年轻成年女性对心血管疾病的知晓情况，并开发一种基于生活方式的心血管风险评估工具，以提高该人群对心血管疾病的认识。
本研究采用三阶段迭代设计流程，研究对象为来自佐治亚州亚特兰大初级保健和生殖保健诊所的年轻女性及医护人员。在第一阶段，我们对15至24岁的年轻女性（n = 67）进行了美国心脏协会女性健康调查的修订版，以评估她们对心血管疾病的总体认识。在第二阶段，我们采访了13至21岁的年轻女性（n = 10）及其医护人员（n = 10），征求关于调整现有成人心血管风险评估工具“健康心脏评分”以适用于该年龄组的建议。我们还旨在进一步了解该人群健康行为改变的障碍和挑战以及为她们提供服务的临床实践情况。在第三阶段，我们利用前两个阶段的研究结果创建了一个专门为年轻女性设计的新型在线心血管风险评估工具的原型。然后，在对该工具进行调整时，我们采用了以用户为中心的迭代设计流程，收集了约105名13至21岁年轻女性的反馈。
在接受调查的年轻女性中，只有10.5%（7/67）正确地将心血管疾病识别为美国女性的首要死因。很少有受访者表示曾与医护人员讨论过自己的个人风险（4/67，6%）或心血管疾病家族史（8/67，11.9%）。在访谈中，年轻女性表示在完成成人风险评估工具后对心血管疾病有了更好的认识和了解，并建议通过纳入相关食物和活动选项，使该工具对青少年更友好。医护人员强调缩短评估时间以便在实践中更易于使用，并讨论了青少年在采取心脏健康行为时可能面临的其他障碍。迭代设计流程的结果是一个对青少年友好的心血管风险评估工具原型。
青少年及年轻成年女性对心血管疾病的知晓度较低。本研究说明了适合年轻女性使用的心血管风险评估工具的潜在价值，并展示了在创建数字健康干预措施时以用户为中心设计的重要性。
