Reduce Health Risk Behaviors Research Articles

Adolescents and young adults' concerns under stress, the COVID-19 pandemic: a Portuguese cross-sectional study.

Adolescents and young adults are a critical target regarding reducing healthrisk behaviors' adoption, particularly in a stressful context such as the COVID-19 pandemic. Surveying their perceptions and behavioral changes may lead to a revised health promotion approach. This study aims to describe adolescents' and young adults' early reactions to a stressful event, the COVID-19 pandemic, characterizing their social determinants and preferences, such as sources of information, experienced symptoms, habits, and main concerns regarding themselves, their relatives, and the community. We intended to explore the association of their concerns and significant determinants such as age, gender, education, source of information, feelings of fear, prospecting the implications of communication, and individual and social determinants in managing stressful events. We conducted a cross-sectional, population-based, self-report survey of 3,898 individuals aged between 16 and 24 years from Portugal. The main concerns about COVID-19 were the possibility of transmitting to someone and permanent social changes. Our findings present significant differences according to gender, education, age, and expressing fear. The pandemic deteriorated baseline community inequalities. Young people appreciate official information and are available to contribute to society's safety. However, valuing official information is associated with deeper expressed concerns. Therefore, official information should include strategies to reach young people, promote healthier choices, and avoid distress and disinformation.

Association of Friendly School and Family Contexts and Reducing Health Risk Behaviors Among Adolescents: A Cross-National Study in Europe, North America, and China.

Social factors play an important role in adolescents' behaviors. This study aims to understand percentages of health risk behaviors across country in Europe, North America, and China; explore the associations between friendly school and family contexts and involvement for several health risk behaviors among adolescents. Data derived from health behavior in school-aged children cross-sectional surveys and China Education Panel Survey in 2014-2015. Hierarchical generalized linear modeling was used to analyze data. The highest percentages of health risk behaviors including unhealthy diet, smoking or alcohol, screen-based sedentary behaviors, and violent behaviors across country ranged from 28.62% to 65.24%. National classmate friendliness was negatively associated with 5 out of 9 health risk behaviors prevalence rates in 41 countries (p < 0.05). Adolescents' perceived peer friendly and helpful were common protective factor for engaging in several health risk behaviors (p < 0.01). Individual family contexts were associated with 3 types of health risk behaviors involvement (p < 0.001). Health risk behaviors among adolescents reducing was associated with the implementation of friendly school and family contexts, emphasizing the significance of the goals of embedding friendly adolescents, along with the home-school collaboration. Public health strategies should promote national climate of friendship and individual perceived friendly school contexts to reduce health risk behaviors.

Factors Influencing Smoking among Multicultural Adolescents.

Since an increasing number of multicultural adolescents have started smoking in Korean society, it is necessary to check the smoking status among multicultural adolescents and provide differentiated smoking cessation education and awareness through intervention programs. This study examined the factors that influenced smoking among multicultural adolescents and identified interventions. This study was a cross-sectional survey. It used raw data from the 15th Korea Youth Risk Behavior Web-based Survey (KYRBS) of 2019. Of the 57,303 participants in the 15th KYRBS, 749 were multicultural adolescents, i.e., their fathers or mothers were not born in Korea. The factors affecting smoking among multicultural adolescents were determined using a composite sample multiple logistic regression analysis. The results of the composite sample multiple logistic regression analysis revealed that 41 (6.4%) participants were smokers, had low academic performance levels, drank alcohol, were sexually active, and were more likely to smoke with other adolescents. They were 15.79 times more likely to smoke while drinking than when not drinking. Educational and psychological interventions are needed to increase multicultural youth school adaptation and academic performance levels, reduce health risk behaviors (drinking and sexually active), and ultimately, lower the smoking rate.

The potential of intervention-based community development programs in reducing multiple health risk behaviors among adolescent: A scoping review of the latest RCTs.

Background: Adolescents are more likely than adults to engage in risky health behaviors such as smoking, drinking, and sexual activity. Community development plays a role in reducing adolescents’ personal, cognitive, and social skill deficits. A review of the effectiveness of community-development interventions is required to advance our understanding of how the intervention reduce health risk behaviors. This study analyze type and effectiveness of adolescents’ community development programs reduce multiple health risk behaviors among adolescents.Methods: This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). With a date range of 2015–2021, searches were conducted in PubMed, EBSCO, and ProQuest using keywords (((Life skill education) OR (community development)) AND ((health risk behavior) OR (risk behavior)) AND ((adolescent) OR (adolescence) OR (teenagers) OR (teens) OR (youth))). After title and abstract checking, full-text retrieval, and data extraction, data were synthesized based on the main objectives. The most important data were tabulated. Results: Most studies showed that community development–based interventions effectively reduce adolescents’ health risk behaviors, including risky sexual behaviors, drug and alcohol use. Interventions were carried out in schools, places of worship, and communities, involving adolescents, educational institutions, health professionals, religious leaders, and families. Conclusion: This review can assist community health nurses, policymakers, researchers, and teachers in developing and implementing effective community-development programs that ensure knowledge, attitudes, and skills transfer to reduce health risk behaviors.

Health Risk Behaviors Affecting Internet Usage in Adolescents: Evidence from the 2018 Korea Youth Risk Behavior Web-Based Survey.

Background:The purpose of this cross-sectional study was to assess the effects of health risk behaviors on the daily Internet usage of Korean high school students.Methods:The data of 19,830 high school students who responded to the Korea Youth Risk Behavior Web-based Survey were analyzed from June to July 2018.Results:The mean daily Internet usage of high school students was 193.3±125.7 minutes. There were differences in daily Internet usage according to body mass index, grade level, school type, academic achievement, economic status, physical activity, number of physical education classes attended, safety accidents, and safety education (p<.05). Daily Internet usage also differed according to health risk behaviors, including smoking (t=8.32), alcohol consumption (t=9.36), drug use (t=4.51), and risky sexual behaviors (t=5.94). The daily Internet usage of students significantly increased in the absence of physical activity and with health risk behaviors such as smoking, alcohol consumption, drug use, and risky sexual behaviors.Conclusion:It is necessary to develop an intervention program and provide education on increasing physical activity and reducing health risk behaviors for the proper management of health and Internet usage in adolescents.

Utilizing Readers Theater for Health Promotion Education in a Rural Setting

Purpose: The aims of the study were to bring in healthy foods, such as fruits and vegetables, provide cardiac health promotion information, and build a community-based partnership with a rural community in West Alabama by soliciting members of the community to participate in and attend a play on cardiovascular health promotion. Sample: The sample population was mostly older African American community members from a non-incorporated, rural area along with individuals from surrounding communities in an Alabama Black Belt county. Through community collaboration, 67 persons were recruited to participate as actors via reading a script and (n =13) and all remaining persons were audience members for the community play (n = 54). Method: This study utilized a community-based participatory research approach with a qualitative, descriptive research design. The Farmers Theater Toolkit, which utilizes a readers theater technique was used to bring cardiovascular health promotion information to a rural community setting. Findings: The majority of audience participants either strongly or somewhat agreed that what they learned from the community play would help them make better food choices (96.3%). Conclusion: Utilizing the Farmers Theater Toolkit in a rural community was an innovative, fun way to share health promotion information. The citizens of this community were very welcoming to the researcher and were excited to partner with an academic institution. Health promotion education may reduce health risk behaviors such as unhealthy food choices. This type of intervention may serve as an impetus to making better food choices. Keywords: rural community, theater, health eating, health promotion DOI: https://doi.org/10.14574/ojrnhc.v22i1.696

Local Education Agency Impact on School Environments to Reduce Health Risk Behaviors and Experiences Among High School Students

PurposeThe purpose of the study is to assess associations between exposure to a multilevel, socio-ecological health program administered by local education agencies and changes in health behaviors among high school students. MethodsThis analysis used a multilevel difference-in-differences approach to compare student health experiences and outcomes between schools selected by local education agencies nationwide to implement the program (exposed schools) and schools that were not (unexposed schools). We measured repeated cross-sectional outcomes using the 2015 and 2017 Youth Risk Behaviors Surveys. The final analytic sample comprised 638 schools in total (N = 64,838 students), with 237 exposed schools (n = 30,336 students) and 401 unexposed schools (n = 34,502 students). ResultsStudents in exposed schools demonstrated significant reduction in odds compared with those in unexposed schools in ever having sex (adjusted odds ratio [aOR] = .88, 95% confidence interval [CI]: .81–.96), having four or more lifetime sexual partners (aOR = .84, 95% CI: .72–.97), being currently sexually active (aOR = .78, 95% CI: .78–.96), and using effective hormonal birth control (aOR = .7, 95% CI: .56–.88). Exposure to the program was associated with significant reduction in odds of not going to school because of safety concerns (aOR = .87, 95% CI: .78–.97), having experienced forced sex (aOR = .76, 95% CI: .68–.86), ever used marijuana (aOR = .89, 95% CI: .81–.98), and currently using marijuana (aOR = .77, 95% CI: .64–.93). ConclusionsExposure to the program was associated with significant decreases in sexual risk behaviors, experience of violence, and substance use.

Development of Well-Being Network of Buddhist-Integrated Manner of Five Precepts Village Communities to Reduce Health Risk Behaviors of Youth in Ratchaburi Province

This research aimed to analyze health conditions and trends, develop a creative media model, and develop a well-being network of Buddhist-integrated manner of five precepts village communities to reduce health risk behaviors of youth in Ratchaburi Province. The research methodology is action research based on the research and development (R&amp;D) model. Research tools include in-depth questionnaires, impact factor analysis form, a specific group chat, and performance evaluation form by indicators. The research results were found that 1. Situation and trends of well-being network of Buddhist-integrated manner of the youth of five precepts village communities in Ratchaburi Province, found that the process position in good execution and is likely to be in the right position, take steps to improve, correct, rehabilitate (VW-0) and find ways to further progress. 2. The model of creative media for the well-being of Buddhist-integrated manner in order to reduce health risk behaviors of youth in Ratchaburi province are "creative media, campaign for not smoking, drinking, taking" by the cooperation of the partners. " well-being network of Buddhist-integrated manner of the youth of five precepts village communities in Ratchaburi Province” 3. well-being network of Buddhist-integrated manner of the youth of five precepts village communities in Ratchaburi Province by focusing on the participation process of social institution. It was found that performance evaluation form by indicator “well-being network of Buddhist-integrated manner of youth in the model area, village communities of the well-being of Buddhist-integrated manner, at the village of keeping five precepts, Tao Poon Community, Ratchaburi Province. The overall level was at a high level, when considering each indicator, it was found that the context, inputs, processes, and productivity were at a high level in all indicators.&#x0D;

Ride hailing app use and drunk/drugged driving among young adult nightclub patrons

Objective Nightclub patrons who consume alcohol and drugs in these venues would appear to be an important population to target with on-demand ride hailing app (RHA) services to reduce drunk/drugged driving (DUI). The present study is an exploratory examination of RHA use to avoid DUI behavior, as well as the perceived barriers and benefits of such RHA use, among young adult nightclub patrons in Miami who use drugs. Methods Completers of a 2011–2015 randomized controlled trial of brief interventions to reduce health risk behaviors among young adult nightclub patrons were recruited to participate in a single self-administered computer-assisted interview about health risks, driving behaviors, and RHA perceptions and use. Recruitment (N = 123) began in June 2016 and ended in July 2017. Bivariable logistic regression and ANOVA models examined group differences between: (a) those who had used an RHA to avoid DUI vs. not; and (b) those who used RHAs as their primary mode of transportation to nightclubs vs. not. Results About half were female (52.8%); median age was 29; 59.4% Hispanic, 31.7% Black, 8.1% white, 0.8% other race/ethnicity. Recent alcohol and marijuana use were almost universally endorsed, and more than half reported recent use/misuse of cocaine (72.4%), MDMA (63.4%), and prescription benzodiazepines (62.6%) and opioids (56.9%). More than 80% reported driving under the influence of alcohol and/or drugs in the past 12 months, and 17.1% experienced a DUI arrest in the prior two years. Almost two-thirds (65.9%) of participants had used an on-demand RHA to avoid DUI, but self-driving or riding in another’s car were the most common (76.4%) primary modes of transportation to clubs. RHAs were the primary mode of travel to clubs for 21 (17.1%) respondents. Participants whose friends strongly disapproved of DUI were more than twice as likely to have used RHAs for this reason compared to those who had not done so. Those reporting RHA use to avoid DUI were less likely than others to have driven under the influence in the past 12 months and were somewhat more likely to endorse DUI-related risks. Those who used alternate modes of transportation were more likely than those who used RHAs as their primary mode of transportation to clubs to endorse the expense of RHAs and the lack of RHA drivers near their favorite clubs as barriers to RHA use to travel to nightclubs. Conclusions This novel study among a high-risk population points to the potential for on-demand RHAs to reduce DUI behaviors and arrests among young adult nightclub patrons who consume alcohol and/or drugs in the context of the club experience. Our findings point to key educational, peer support, and structural targets for intervention to increase the use of RHAs among this population, specifically, club-based incentives for increasing RHA availability and affordability. Research is needed to fully elucidate the findings of this exploratory study, including potential differences in intervention approaches depending on the location-specific public transportation options.

Depressive Symptoms, Suicidal Ideation, and Mental Health Service Use of Industrial Workers: Evidence from Vietnam.

Background: Depressive symptoms and suicidal ideation substantially reduce industrial workers’ productivity and performance. This study was performed to examine the prevalence of depressive symptoms and suicidal ideation and identify associated factors among industrial workers in different provinces of Vietnam. Materials and Methods: We performed a cross-sectional study in industrial zones of four provinces of Vietnam. The Patient Health Questionnaire (PHQ-9) was employed to screen depressive symptoms and suicidal ideation. Multivariate logistic regression was performed to determine factors related to depressive symptoms and suicidal ideation. Results: Of 1200 industrial workers, 30.5% and 33.6% industrial workers had positive depressive symptoms and suicidal ideation in the last two weeks, respectively. There were 38.3% ever using mental health services in the last 12 months. High school education (OR = 0.64, 95% CI = 0.44–0.95); living in dormitory (OR = 3.07, 95% CI = 1.51–6.24), living with siblings (OR = 2.98; 95% CI = 1.32–6.75), having two children or more (OR = 1.45, 95% CI = 1.03–2.03), high years of experience (OR = 0.94; 95% CI = 0.89–0.98), suffering from burnout, alcohol use disorder (OR = 2.38; 95% CI = 1.72–3.28), and smoking status (OR = 0.38, 95% CI = 0.23–0.61) were associated with positive depressive symptoms. Living with children, working in mechanical/metallurgy/electronics factories, completely exhausted and often thinking of quitting, and alcohol use disorder were positively related to suicidal ideation. Conclusions: This study found a high prevalence of depressive symptoms and suicidal ideation among industrial workers in Vietnam. Regular screening and detecting high-risk groups, along with interventions to reduce health risk behaviors, burnout and on-site medical service quality improvement, are recommended to alleviate the burden of depression in industrial workers.

Evaluation of a Motivation-Based Intervention to Reduce Health Risk Behaviors among Black Primary Care Patients with Adverse Childhood Experiences.

Considerable evidence suggests that greater attention should be paid to the impact of trauma among low-income, racial/ethnic minority patients living in urban communities. The goal of this article is to evaluate a 2-session, motivational intervention designed to motivate a change in health risk behaviors among low-income, self-identified Black/African American patients with adverse childhood experiences (ACEs). Qualitative self-reported data described helpful aspects of the intervention and those that could be improved. Eligible participants with 1 or more ACEs being seen in a community-based clinic were interviewed by a mental health clinician researcher for 2 in-person sessions scheduled 1 month apart. Content analysis was performed using a general inductive approach to identify core themes. In total, 36 of 40 participants completed both sessions, with the majority reporting a high rate of satisfaction. Participants emphasized the importance of talking with a trained professional who could listen without judgment, understand patient challenges, clarify patient goals, and facilitate behavior change plans. Suggestions for improvement included modifying structure and content, enhancing clinic environment, improving linkages to behavioral health, and increasing communication and collaboration with clinicians. Participant evaluation data gathered for this study suggest that through the practice of asking, listening, and accepting, clinicians can help patients who have been exposed to childhood adversity better understand themselves and promote healthy coping behaviors. This study provides preliminary data on the needs of underserved patients that can be utilized to develop and deliver health promotion interventions using a trauma-informed approach in community-based clinics.

Social correlates of sedentary behavior in young people: The UP&DOWN study

PurposeThe aim of the present study was to analyze the associations of youths’ sedentary behavior (SB) with parents’ and siblings’ SB and physical activity (PA), as well as the associations of youths’ coparticipation with parents, siblings, and friends in PA and SB with youths’ SB. MethodsThe sample consisted of 1543 youths (12.02 ± 2.51 years; 788 boys) enrolled in the baseline cohort of the UP&DOWN study. SB was assessed by accelerometry and questionnaire. Participants reported the time spent by their parents and siblings watching television, playing videogames, surfing the Internet, sitting/resting, and doing PA. Further, participants reported coparticipation with parents, siblings, and friends in these activities. Linear mixed models, including school and city as random effects, were performed. ResultsParents’ television time was positively associated with youths’ screen-based SB. Coparticipation with friends in playing videogames (in boys) and in surfing the Internet (in girls) showed a positive association with screen-based SB and a negative association with educational-based SB. Moreover, coparticipation with siblings and friends in PA was inversely associated with accelerometer-based SB in boys and girls. ConclusionOur results emphasize the important role of social modeling in the development of sedentary lifestyles in youths. Interventions aimed at reducing health risk behaviors in youths could be more effective if they are oriented from a social perspective that involves their families and networks of their closest friends.

A Preliminary Randomized Controlled Trial of Game Plan, A Web Application to Help Men Who Have Sex with Men Reduce Their HIV Risk and Alcohol Use.

Alcohol use is a key risk factor for HIV infection among men who have sex with men (MSM). Past studies show that brief motivational interventions (BMI) can increase the use of prevention methods (e.g., condoms), reduce alcohol use, and can be adapted for web-based delivery. However, few studies have explored these interventions' effects in MSM. Forty high-risk, heavy drinking MSM who sought rapid HIV testing were randomly assigned to receive either (1) standard post-test counseling (SPC) alone, or (2) SPC plus Game Plan (GP), a tablet tablet-based BMI for alcohol use and HIV risk. Over three months of follow-up, GP participants reported 24% fewer heavy drinking days, 17% fewer alcohol problems, and 50% fewer new anal sex partners than controls. GP participants also reported fewer high-risk condomless anal sex events than controls, but these differences were not significant. These initial results suggest that web-based BMIs may be promising tools to help MSM reduce health risk behaviors.

Reducing Health Risk Behaviors and Improving Depression in Adolescents: A Randomized Controlled Trial in Primary Care Clinics.

Primary care (PC) is a major service delivery setting that can provide preventive behavioral health care to youths. To explore the hypothesis that reducing health risk behaviors (HRBs) would lower depressive symptoms, and that health risk and depression can be efficiently targeted together in PC, this study (1) evaluates an intervention designed to reduce HRBs among adolescent PC patients with depressive symptoms and (2) examines prospective links between HRBs and depressive symptoms. A Randomized controlled trial was conducted comparing a behavioral health intervention with enhanced Usual PC (UC+). Participants were 187 adolescents (ages 13-18 years) with past-year depression, assessed at baseline, 6 months, and 12 months. Primary outcome was the Health Risk Behavior Index (HRBI), a composite score indexing smoking, substance use, unsafe sex, and obesity risk. Secondary/exploratory outcomes were an index of the first three most correlated behaviors (HRBI-S), each HRB, depressive symptoms, and satisfaction with mental health care. Outcomes were similar at 6 and 12 months, with no significant between-group differences. HRBI, HRBI-S, and depressive symptoms decreased, and satisfaction with mental health care increased across time in both groups. HRBI, HRBI-S, and smoking predicted later severe depression. Conversely, severe depression predicted later HRBI-S and substance use. UC+ and the behavioral health intervention yielded similar benefits in reducing HRBs and depressive symptoms. Findings underscore the bidirectional links between depression and HRBs, supporting the importance of monitoring for HRBs and depression in PC to allow for effective intervention in both areas.

Risk and protection factors for chronic noncommunicable diseases in adolescents in Brazilian capitals.

To analyze trend estimates on the prevalence of risk and protective behaviors for chronic noncommunicable diseases in adolescents, according to data from the National School Health Survey in 2009, 2012 and 2015. Data from the three cross-sectional studies in Brazilian capitals and the Federal District were used. In total, 173,310 adolescents enrolled in the ninth grade of elementary school were interviewed, with average age of 14 years. The prevalence of indicators of protective (consumption of beans and fruit; physical education classes at school; practice of physical activity for 60 minutes or more) and risk factors (consumption of candies and soft drinks; use of cigarettes and alcohol in the last 30 days; drug testing) were estimated through linear regression. There was a significant increase (p < 0.05) in the prevalence of fruit consumption and in the reduction of bean, soft drinks and candies consumption, as well as the consumption of alcoholic beverages and cigarettes. However, an increase in the prevalence of illicit drug experimentation was observed. Discussion: Despite the tendency to reduce risk factors, prevalences are high when compared with other sociocultural realities. The school is an important area of access to the adolescent public, and it is necessary to encourage school health promotion programs to reduce health risk behaviors, as well as to stimulate protective ones.

Relationship between unintentional injury and health risk behaviors among adolescents

Objective To identify the effect of health risk behaviors on accidental injury of adolescents.Then analyze the strength and approach of the health risk behaviors. Methods Cluster sampling on various stages and strata methods was adopted.The adolescents from grade one to three in junior school students and grade one to three in senior high school students completed the questionaire. A total of 4 408 students were surveyed and 4 309 samples were valid. Path analysis was used to understand how factors could influence injury incidence. Results The incidence of adolescent injury was 15.53%. Statistical differences were found between genders (male 17.77%, female 13.36%, χ2=15.91, P<0.01), education levels (junior high school 17.36%, senior high school 13.99%, χ2=11.45, P<0.01) and cities (Beijing 12.97%, Zhongshan 17.95%, χ2=20.33, P<0.01). Those who got injured were found with more health risk behaviors. Health risk behavior was the direct influencing factor to injury, as well as a possible risk factor to multiple injuries. Conclusion Health risk behaviors can strongly affect adolescent injury, and can be an indicator. Reducing health risk behaviors is important in adolescent injury prevention. Key words: Adolescent; Accidental injury; Health risk behavior; Path analysis

Pilot Study.

A significant proportion of youth engage in health risk behaviors, which are of concern, as they are associated with adverse health consequences across development. Two factors associated with engagement in such behaviors are emotion dysregulation and impulsivity. Dialectical behavioral therapy (DBT) is an effective intervention that enhances emotion regulation skills to reduce problem behaviors among adolescent populations; however, limited research has been conducted implementing the program within school settings. The current study was a 9-week DBT skills group conducted among 80 middle school youth, with pre-posttest data among 53 students. Findings indicated feasibility to implement the program in schools and preliminary evidence of efficacy in decreasing youth's likelihood to engage in risky, particularly among youth high on an emotion-based impulsivity trait. Brief DBT skills group may be an effective program to be utilized by school nurses and health-care teams to reduce health risk behaviors among school-aged youth.

The 1-year impact of an emotion regulation intervention on early adolescent health risk behaviors.

Sexual activity often begins in early adolescence, and adolescents with mental health symptoms are at greater risk for sexual activity and other health risks. This study aimed to evaluate a developmentally targeted intervention designed to enhance early adolescents' emotion regulation competencies as a strategy for reducing health risk behaviors, including sexual initiation. Adolescents 12 to 14 years old (N = 420; 53% male) with mental health symptoms participated in either an emotion regulation (ER) or health promotion (HP) intervention consisting of 12 after-school sessions. Participants completed questionnaires on laptop computers at baseline, 2-, 6-, and 12-month follow-ups. Time to event analyses were used to compare intervention conditions on rate of initiation to vaginal sex. Results showed that participants in the ER condition were less likely to transition into vaginal sexual activity by 1-year follow-up than were those in the HP condition (adjusted hazard ratio = 0.58, 95% confidence interval [0.36, 0.94], p = .01). However, those who were sexually active did not report differences in sexual risk behaviors (e.g., condomless sex). Participants in the ER condition were significantly less likely to report violence behaviors and showed improvement on a behavioral measure of emotion identification; however, they did not differ from HP participants on self-reports of emotional competence. Emotion regulation strategies can be used to delay sexual initiation among early adolescents with mental health symptoms and may have an important role in health education. (PsycINFO Database Record

Circulation : Clinical Summaries

<i>Circulation</i> : Clinical Summaries

Trauma Exposure and Posttraumatic Stress Disorder Symptoms Predict Onset of Cardiovascular Events in Women

Psychological stress is a proposed risk factor for cardiovascular disease (CVD), and posttraumatic stress disorder (PTSD), the sentinel stress-related mental disorder, occurs twice as frequently in women as men. However, whether PTSD contributes to CVD risk in women is not established. We examined trauma exposure and PTSD symptoms in relation to incident CVD over a 20-year period in 49 978 women in the Nurses' Health Study II. Proportional hazards models estimated hazard ratios and 95% confidence intervals for CVD events confirmed by additional information or medical record review (n=548, including myocardial infarction [n=277] and stroke [n=271]). Trauma exposure and PTSD symptoms were assessed by using the Brief Trauma Questionnaire and a PTSD screen. In comparison with no trauma exposure, endorsing ≥4 PTSD symptoms was associated with increased CVD risk after adjusting for age, family history, and childhood factors (hazard ratio,1.60; 95% confidence interval, 1.20-2.13). Being trauma-exposed and endorsing no PTSD symptoms was associated with elevated CVD risk (hazard ratio, 1.45; 95% confidence interval, 1.15-1.83), although being trauma-exposed and endorsing 1 to 3 PTSD symptoms was not. After adjusting for adult health behaviors and medical risk factors, this pattern of findings was maintained. Health behaviors and medical risk factors accounted for 14% of the trauma/no symptoms-CVD association and 47% of the trauma/4+ symptoms-CVD association. Trauma exposure and elevated PTSD symptoms may increase the risk of CVD in this population of women. These findings suggest that screening for CVD risk and reducing health risk behaviors in trauma-exposed women may be promising avenues for prevention and intervention.