Abstract P050: Competing Health Priorities Lead Young Women to Worry Little About Heart Disease

Abstract

Introduction: The American Heart Association (AHA) Go Red for Women campaign has substantially improved heart disease awareness among adult women. Little is known about how younger women in adolescence and young adulthood (AYA) perceive their risk of heart disease during this key time in the life course for primordial prevention. Methods: We used an explanatory sequential mixed method design consisting of the AHA National Women’s Health Study survey and follow-up focus groups. We surveyed a random convenience sample of 331 AYA women ages 15-24 years presenting for care at an urban academic medical center and a community health center. Survey results guided development of a qualitative guide used during eight online, semi-structured focus groups with 32 young women. We report descriptive statistics performed using Matlab (Mathworks, Inc.) and thematic analyses conducted to synthesize data from the online focus groups using NVivo 11. Results: Only 10% [n=33] of AYA identified heart disease as the leading cause of death in women. Very few identified it as the top health concern for women of all ages [16 (4.8%)] or women in their age group [3 (0.9%)]. Most young women surveyed worried little [131 (39.6%)] or not at all [123 (37.2%)] about getting heart disease. In contrast, mood disorders were the most commonly noted top health concern for women of all ages [66 (19.9%)] and women in their age group [59 (17.8%)] and many AYA [142 (42.9%)] worried a lot about getting depression or anxiety. AYA discussed age (“I feel like those are things I associate with older people like 40”), competing health priorities (“because we’re so pressured just to grow up and more focused on pregnancies or depression or our weight”), and lack of perceived risk (“I like to think that I’m conscious of what I eat and drink”) as personal reasons for not worrying about heart disease. At the end of the focus group discussions, AYA women expressed being more motivated to both learn about heart health and to perform heart healthy behaviors (“I am definitely more motivated because I wasn’t aware that it was the number one kill[er] so I will definitely make sure to start working out”). Many group participants also noted the importance of receiving heart health information as well as personalized risk information from doctors. Conclusions: Younger women are unaware that heart disease is the leading cause of death in women and express little worry about their future risk. As the antecedents of heart disease begin in childhood and adolescence, these findings demonstrate a major unmet need. Campaigns to promote heart healthy behaviors in young women should directly address low perceived risk, the importance of lifetime risk, and competing health priorities with both young women and their health care providers.