Abstract
BackgroundPoverty increases the risk of cardiac disease, while diminishing the resources available to mitigate that risk. Available prevention programs often require resources that low-income residents of urban areas do not possess, e.g. membership fees, resources to purchase healthy foods, and safe places for physical activity. The aim of this study is to obtain participant input in order to understand the health-related goals, barriers, and strengths as part of planning a program to reduce cardiovascular risk.MethodsIn a mixed methods study, we used written surveys and focus groups as part of planning an intervention specifically designed to meet the needs of lower income individuals. Based on prior research, we used Self-Determination Theory (SDT) and its core constructs of autonomy, competence, and relatedness as the theoretical framework for analysis. The study collected information on the perspectives of low-income urban residents on their risks of cardiovascular disease, their barriers to and supports for addressing health needs, and how they addressed barriers and utilized supports. Focus group transcripts were analyzed using standard qualitative methods including paired coding and development of themes from identified codes.ResultsParticipants had health goals that aligned with accepted approaches to reducing their cardiovascular risks, however they lacked the resources to reach those goals. We found a lack of support for the three SDT core constructs. The barriers that participants reported suggested that these basic psychological needs were often thwarted by their environments.ConclusionsSubstantial disparities in both access to health-promoting resources and in support for autonomy, competence, and relatedness must be addressed in order to design an effective intervention for a low-income population at cardiac risk.
Highlights
Poverty increases the risk of cardiac disease, while diminishing the resources available to mitigate that risk
Our analysis found that SelfDetermination Theory (SDT) constructs are useful in framing the perspectives of participants, we did not include focus group questions that explicitly asked about SDT core components
While SDT is frequently studied among non-poor populations, we argue that this framework may be even more important in supporting core psychological needs in a low-income population
Summary
Poverty increases the risk of cardiac disease, while diminishing the resources available to mitigate that risk. Even in this decade, individuals who are African American have a 27% higher age-adjusted death rate from CVD than the general population [2], and persons aged 35 to 64 in the lowest quartile of socioeconomic status are twice as likely to die from myocardial infarction and coronary heart disease compared to those in the higher quartiles. These disparities mirror the significant disparities in the prevalence of seven key risk factors: smoking, physical inactivity, obesity, poor diet, hypertension, high cholesterol, and abnormal fasting glucose [3]. Increased frequency of ACEs correlates with incidence of cardiovascular disease [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
