Abstract P096: Developing A Lifestyle-Based Cardiovascular Health Tool For Teens

Abstract

Purpose: Previous studies have shown that young women have low awareness of heart disease, despite cardiovascular (CV) disease being the number one cause of death in women. While CV risk assessment tools exist for adults, there are no similar tools specifically for adolescents. This project focuses on developing a lifestyle-based CV health prediction tool and behavior intervention for young women. Methods: We report a qualitative case study of four hour-long semi-structured interviews with young women aged 13-21 years participating in a larger study to develop the new CV health tool. Patients were recruited from a primary care practice in Atlanta, GA. Participants completed the Healthy Heart Score survey, an existing web-based CV prediction tool developed for adults, while providing feedback on how to adapt the tool for young women. Topics included conditions to engage with the tool (e.g. at school or doctor’s office), app architecture (including layout, word choice, and use of visuals), and suggestions for improvement of the tool. We used qualitative coding and thematic analyses to synthesize data. Results: Prior to engaging with the Heart Healthy Score tool, participants initially demonstrated minimal knowledge of heart attacks/strokes (“I don’t know about preventing” [heart attacks and strokes]) and of their own risk (“I’ve never associated… young women with [heart disease]”). As participants used the tool, their knowledge of heart healthy choices and awareness of their own choices increased, cueing action (“I definitely need to get my health… together now before it’s too late”). Throughout the survey, teens had varied emotional reactions, from shame/embarrassment about health (“I… got upset because… I shouldn’t be eating this much”), to surprise/shock (“I thought I ate way more fruits and vegetables''), to enthusiasm to engage with app in the future (“I might like to use this tool because it’ll … help me [have] a better way of understanding … what to eat, what is healthy”). Participant recommendations to improve the tool for future use with teens focused on the importance of using examples and visual representations (“All the examples … really help me … figure out … how much I’m eating”, “I don’t really have a good idea of… what ounces really look like… a little visual would help [figure] that out”), and the importance of goal-setting and motivational language to incentivize teens to engage with the tool (“Instead of just telling you what you need to do to become better, they give you… an actual goal”). Conclusions: Through this case study, young women demonstrate a knowledge gap about heart disease risk and healthy choices. Adapting a CV health assessment tool for teens, with added examples, visuals, and motivational language, will allow teens to reflect on their own lifestyle choices, increase awareness of their risk for future heart disease, and ultimately serve as an impetus for behavior change.