Johns Hopkins School of Nursing, Baltimore, MD.
Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD.
Am Heart J. 2024 Sep;275:151-162. doi: 10.1016/j.ahj.2024.05.016. Epub 2024 Jun 9.
BACKGROUND: Cardiovascular health literacy (CVHL) and social determinants of health (SDoH) play interconnected and critical roles in shaping cardiovascular health (CVH) outcomes. However, awareness of CVH risk has declined markedly, from 65% of women being aware that cardiovascular disease (CVD) is the leading cause of death for women in 2009 to just 44% being aware in 2019. The American Heart Association Research Goes Red (RGR) initiative seeks to develop an open-source, longitudinal, dynamic registry that will help women to be aware of and participate in research studies, and to learn about CVD prevention. We proposed to leverage this platform, particularly among Black and Hispanic women of reproductive age, to address CVHL gaps and advance health equity. METHODS: The primary objective of the study is to evaluate the cross-sectional association of CVHL, SDoH using a polysocial score, and CVH in women of reproductive age at increased risk of developing hypertension (HTN). To achieve this we will use a cross-sectional study design, that engages women already enrolled in the RGR registry (registry-enrolled). To enhance the racial and ethnic/social economic diversity of the cohort, we will additionally enroll 300 women from the Baltimore and Washington D.C. community into the Social Determinants of the Risk of Hypertension in Women of Reproductive Age (SAFE HEART) Study. Community-enrolled and registry-enrolled women will undergo baseline social phenotyping including detailed SDoH questionnaire, CVH metrics assessment, and CVHL assessment. The secondary objective is to assess whether a 4-month active health education intervention will result in a change in CVHL in the 300 community-enrolled women. DISCUSSION: The SAFE HEART study examines the association between CVHL, SDoH, and CVH, with a focus on racial and ethnic minority groups and socioeconomically disadvantaged women of reproductive age, and the ability to improve these parameters by an educational intervention. These findings will inform the future development of community-engaged strategies that address CVHL and SDoH among women of reproductive age.
背景:心血管健康素养 (CVHL) 和健康的社会决定因素 (SDoH) 在塑造心血管健康 (CVH) 结果方面发挥着相互关联且至关重要的作用。然而,人们对心血管疾病 (CVD) 风险的认识显著下降,从 2009 年 65%的女性意识到 CVD 是女性死亡的主要原因,下降到 2019 年只有 44%的女性意识到这一点。美国心脏协会研究红色倡议 (RGR) 旨在开发一个开源、纵向、动态的登记处,以帮助女性了解并参与研究,以及了解 CVD 预防。我们建议利用这个平台,特别是在处于生育年龄的黑人和西班牙裔女性中,以解决 CVHL 差距和促进健康公平。
方法:该研究的主要目的是评估 CVHL、使用多社会评分的 SDoH 以及处于高血压 (HTN) 高发风险的生育期女性的 CVH 在横断面研究中的相关性。为了实现这一目标,我们将使用横断面研究设计,让已经注册 RGR 登记处的女性参与进来(登记处登记)。为了增强队列的种族和民族/社会经济多样性,我们还将从巴尔的摩和华盛顿特区社区招募 300 名生育期女性进入社会决定因素的风险的高血压妇女研究(SAFE HEART)。社区登记和登记处登记的女性将接受基线社会表型评估,包括详细的 SDoH 问卷、CVH 指标评估和 CVHL 评估。次要目标是评估为期 4 个月的积极健康教育干预是否会导致 300 名社区登记女性的 CVHL 发生变化。
讨论:SAFE HEART 研究检查了 CVHL、SDoH 和 CVH 之间的关联,重点关注少数族裔和社会经济处于不利地位的生育期女性,以及通过教育干预改善这些参数的能力。这些发现将为未来制定针对生育期女性的 CVHL 和 SDoH 的社区参与策略提供信息。
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