Ahn Soojung, Son Elisa H, Mogos Mulubrhan F, Muchira James M, Sheng Ying, Park Chorong, Lee Lena J
Connell School of Nursing, Boston College, Chestnut Hill, MA, United States.
Translational Biobehavioral and Health Promotion, National Institutes of Health Clinical Center, Bethesda, MD, United States.
Front Public Health. 2025 Jun 17;13:1593898. doi: 10.3389/fpubh.2025.1593898. eCollection 2025.
Lifestyle risk behaviors for cardiovascular disease (CVD) often co-occur. However, little is known about their co-occurrence patterns among family caregivers, a high-risk population for CVD. This study aimed to identify distinct latent classes of lifestyle risk behaviors for CVD among caregivers and to examine socio-demographic, health-related, and caregiving characteristics associated with membership in the latent classes.
We conducted a cross-sectional secondary data analysis of the 2019 Health Information National Trends Survey 5 Cycle 3, involving 643 unpaid family caregivers in the United States. The lifestyle risk behaviors for CVD included current cigarette use, current alcohol consumption, low physical activity, prolonged sedentary time, low fruit intake, and low vegetable intake, as defined by established guidelines. We performed latent class analysis to identify unobserved subgroups based on these multiple lifestyle risk behaviors. Subsequently, we conducted multinomial logistic regression to investigate socio-demographic, health-related, and caregiving characteristics associated with latent class membership.
The majority of participants were females (55.3%) and non-Hispanic white (57.1%), with a mean age of 55 ± 16 years. Three distinct classes were identified: Class 1 ( 17.1%), Class 2 ( 18.8%), and Class 3 ( 64.1%). In unadjusted models, older caregivers (≥65 years) were more likely to belong to Class 2, relative to Class 1, compared to those aged 18-49 years. Caregivers with perceived financial difficulties, psychological distress, low self-efficacy in health management, and poor sleep quality were more likely to belong to Class 3, rather than Class 1, compared to their counterparts. Additionally, dementia care and caregiving ≥ 20 h/week were significantly associated with Class 3 membership. In the adjusted model, psychological distress remained significant. Caregivers reporting psychological distress were more likely to belong to Class 3 rather than Class 1, compared to those without psychological distress.
Our findings reveal the presence of subgroups of caregivers with unique patterns of lifestyle risk behaviors, with most not meeting the recommended levels of health behaviors. Future studies should consider these co-occurring patterns along with the key factors associated with higher-risk lifestyle behavior patterns when developing interventions to promote caregivers' cardiovascular health.
心血管疾病(CVD)的生活方式风险行为常常同时出现。然而,对于家庭照料者这一CVD高危人群中这些行为的共现模式,我们知之甚少。本研究旨在识别照料者中CVD生活方式风险行为的不同潜在类别,并考察与潜在类别归属相关的社会人口学、健康相关及照料特征。
我们对2019年美国健康信息国家趋势调查第5周期第3轮进行了横断面二次数据分析,涉及643名美国无薪家庭照料者。根据既定指南,CVD的生活方式风险行为包括当前吸烟、当前饮酒、低体力活动、久坐时间延长、水果摄入量低和蔬菜摄入量低。我们进行潜在类别分析,以基于这些多种生活方式风险行为识别未观察到的亚组。随后,我们进行多项逻辑回归,以研究与潜在类别归属相关的社会人口学、健康相关及照料特征。
大多数参与者为女性(55.3%)和非西班牙裔白人(57.1%),平均年龄为55±16岁。识别出三个不同类别:第1类(17.1%)、第2类(18.8%)和第3类(64.1%)。在未调整模型中,与18 - 49岁的照料者相比,年龄较大的照料者(≥65岁)相对于第1类更有可能属于第2类。与同伴相比,如果照料者存在经济困难、心理困扰、健康管理自我效能低以及睡眠质量差,则更有可能属于第3类而非第1类。此外,痴呆照料和每周照料≥20小时与第3类归属显著相关。在调整模型中,心理困扰仍然显著。与没有心理困扰的照料者相比,报告有心理困扰的照料者更有可能属于第3类而非第1类。
我们的研究结果揭示了存在具有独特生活方式风险行为模式的照料者亚组,大多数照料者未达到推荐的健康行为水平。未来研究在制定促进照料者心血管健康的干预措施时,应考虑这些共现模式以及与高风险生活方式行为模式相关的关键因素。