Abstract 12229: Health Literacy, Adherence to Self-Care Behaviors, and Ten-Year Cardiovascular Disease Risk in Central Appalachian Residents

Abstract

Background: Appalachian Kentucky has disproportionately higher rates of cardiovascular disease (CVD) and associated risk factors than the rest of the U.S. Health literacy and adherence to CVD risk reduction self-care behaviors are important predictors of health outcomes and may play a major role in modifying CVD risk. Objective: To examine the relationships among health literacy, adherence to self-care behaviors and 10-year CVD risk in Central Appalachian residents. Method: This was a sub-analysis of baseline data of a randomized control trial in 844 Central Appalachian residents (male 25%, age 51± 14, Caucasian 95%) without major CVD (e.g., coronary artery disease, stroke). Health literacy was assessed by the Newest Vital Sign (NVS), and adherence to self-care behaviors by the Medical Outcomes Study Specific Adherence Scale. Ten-year CVD risk points were calculated from the Framingham formula based on age, high density lipoprotein, total cholesterol, systolic blood pressure (treated & untreated), smoking status, and diagnosis of diabetes. Linear regressions were used to examine the relationships among health literacy, adherence to self-care behaviors, and 10-year CVD risk. Results: Based on the NVS, 12% of residents had limited health literacy. Residents who had limited health literacy were more likely to have higher 10-year CVD risk than those with adequate health literacy ( p = .014). Health literacy was not correlated with adherence to self-care behaviors. Unadjusted regressions revealed that both health literacy and adherence to self-care behaviors predicted 10-year CVD risk ( p = .002 and < .001, respectively). After adjustment for the covariates (age, gender, ethnicity, marital status, employed status), only adherence to self-care behaviors predicted 10-year CVD risk ( p = .012) Conclusion: Poor adherence to self-care behaviors predicts higher 10-year CVD risk. The lack of independent relationship between health literacy and self-care adherence, and health literacy and outcome suggests that adherence to effective self-care may be fostered despite low health literacy. It is important to design and implement effective interventions to enhance adherence to self-care behaviors to reduce 10-year CVD risks in Central Appalachian residents.