Risk Perception In Women Research Articles

The women's cardiovascular disease risk perception after hypertensive disorders of pregnancy: A qualitative meta-synthesis

BackgroundHypertensive disorders of pregnancy is associated with increased risk of cardiovascular disease later in life, but studies suggest that women with previous hypertensive disorders of pregnancy are not aware of this. Little is known about how these women perceive the condition and the associated long-term risks. ObjectivesThis study aims to examine and synthesize qualitative evidence on the perceptions and awareness of women with hypertensive disorders of pregnancy following perceived cardiovascular disease risk. MethodsComputer searches of Pub Med, Embase, Web of Science, Cochrane Library, CINAHL, CNKI, Wanfang database, Vip and SinoMed for all qualitative studies that met the inclusion criteria. The time frame for the search was from the establishment of the database to April 2024. Literature quality was assessed using the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Qualitative Research quality assessment criteria, and results were summarised and integrated using a pooled integration approach. ResultsEleven studies that fulfilled the inclusion criteria and quality assessment were included in the meta synthesis. Three themes were identified during the analysis: (1)Factors affecting perceived cardiovascular risk in women with hypertensive disorders of pregnancy; (2)Women with hypertensive disorders of pregnancy use different strategies to cope with cardiovascular risk; (3)Needs and expectations for coping with cardiovascular disease risk. ConclusionsBoth women with hypertensive disorders of pregnancy and healthcare providers lack knowledge of the link between hypertensive disorders of pregnancy and cardiovascular risk. Healthcare professionals should establish a multidimensional support model, pay timely attention to postpartum women's psycho-emotional and risk awareness, and give individualised health education to promote health behaviour change. At the same time, professionals should be given standardised training and personalised follow-up services to reduce the incidence of cardiovascular disease in the future.

Effect of Comprehensive Educational Program on Preeclamptic Women's Risk Perception of Cardiovascular Disease, Self-Efficacy, and Adherence to Healthy Lifestyle Behaviors.

To evaluate the effect of a comprehensive educational program on preeclamptic women's knowledge, risk perception of cardiovascular disease, self-efficacy, and adherence to healthy lifestyle behaviors. This study employed a pretest-posttest design. One hundred and two women who previously had preeclampsia were enrolled from July 2022 to December 2022 from outpatient obstetrics, gynecology, and family planning clinics. The primary and secondary outcomes were measured at baseline, after eight weeks, and after three months of the educational intervention. The data were analyzed using SPSS version 23, descriptive and inferential statistics, specifically the Chi-square test, independent t-tests, and repeated measures ANOVA. A statistically significant difference was found between the two groups immediately post-intervention and the three-month follow-up, with a significant improvement among the intervention group than control group regarding cardiovascular disease knowledge (p < 0.001), risk perception (p < 0.001), self-efficacy (p < 0.001), and healthy lifestyle behaviors (p < 0.001). There was a statistically significant interaction between group and time regarding total cardiovascular disease risk perception (F = 203.67, p < 0.001, η2 = 0.673), self-efficacy (F = 70.06, p < 0.001, η2 = 0.405), and adherence to healthy lifestyle behaviors (F = 145.08, p < 0.001, η2 = 0.597). This study concluded that the comprehensive educational program had a positive effect on improving preeclamptic women's knowledge and risk perception of CVD, self-efficacy, and adherence to healthy lifestyle behaviors following preeclampsia.

Development, validation and reliability of scales and items for heat wave risk assessment of pregnant women.

The 1.2°C rise of global ambient temperature since the pre-industrial era has led to an increase the intensity and frequency of heatwaves. Given the heightened vulnerability of pregnant women to heat stress, there is an urgent need for tools which accurately assess the knowledge, risk, and perception of pregnant woman toward heatwaves, enabling effective policy actions. In this research, we developed and validated tools to evaluate pregnant women's perceptions of heat wave risks and behaviors. We developed 50 items across seven constructs using the Health Belief Model, identified through a systematic literature review. The constructs comprised 8 Knowledge(K) items, 4 in Perceived Vulnerability (PV), 5 in Perceived Severity (PS), 6 in Perceived Benefit (PB), 4 in Perceived Barrier (PBa), 5 in Cue to Action(Cu) and 18 in Adaptation(A). Cognitive testing was performed with a separate group of pregnant women(n = 20). The tested tools were then administered to 120 pregnant women residing during the spring-summer 2023. Construct validation utilized exploratory factor analysis. The Principal Axis Factoring Method was employed in the EFA with oblimin rotation for 51 items, considering communality > 0.20, and aiming to extract three factors. Across the three factors with Cronbach's alpha > 0.70, a total of 11 items were distributed. Factor 1 included Perceived Severity (PS1, PS2, PS3 and PS5); Factor 2 included Cue to Action (Cu1, Cu2, Cu3, and Cu4); and Factor 3 encompassed Perceived Vulnerability (PV1, PV2, PV4). Only two of the retained items had factor loadings > 0.50, namely PV4 and PS5. Consequently, the three constructs measuring Perceived Severity, Cues to Action, and Perceived Vulnerability using the HBM among pregnant women were deemed valid. Our study has successfully validated a highly reliable tool which stands ready for application in assessing pregnant women's risk perception regarding heatwaves.

Assessment of Sexual Violence Risk Perception in Men Who Have Sex With Men: Proposal for the Development and Validation of "G-Date".

Sexual violence (SV) is a significant problem for sexual minorities, including men who have sex with men (MSM). The limited research suggests SV is associated with a host of syndemic conditions. These factors tend to cluster and interact to worsen one another. Unfortunately, while much work has been conducted to examine these factors in heterosexual women, there is a lack of research examining MSM, especially their SV risk perception. Further, MSM are active users of dating and sexual networking (DSN) mobile apps, and this technology has demonstrated usefulness for creating safe spaces for MSM to meet and engage partners. However, mounting data demonstrate that DSN app use is associated with an increased risk for SV, especially given the higher likelihood of using alcohol and other drugs before sex. By contrast, some researchers have demonstrated that DSN technology can be harnessed as a prevention tool for HIV; unfortunately, no such work has progressed regarding SV. This study aims to (1) use qualitative and quantitative methods to tailor an existing laboratory paradigm of SV risk perception in women for MSM using a DSN mobile app framework and (2) subject this novel paradigm to a rigorous validation study to confirm its usefulness in predicting SV, with the potential for use in future prevention endeavors. To tailor the paradigm for MSM, a team of computer scientists created an initial DSN app (G-Date) and incorporated ongoing feedback about the usability, feasibility, and realism of this tool from a representative sample of MSM. We used focus groups and interviews to assist in the development of G-Date, including by identifying relevant stimuli, developing the cover story, and establishing the appropriate study language. To confirm the paradigm's usefulness, we are conducting an experimental study with web-based and face-to-face participants to determine the content, concurrent, and predictive validities of G-Date. We will evaluate whether certain correlates of SV informed by syndemics and minority stress theories (eg, history of SV and alcohol and drug use) affect the ability of MSM to detect SV risk within G-Date and how paradigm engagement influences behavior in actual DSN app use contexts. This study received funding from the National Institute on Alcohol Abuse and Alcoholism on September 10, 2020, and ethics approval on October 19, 2020, and we began app development for aim 1 immediately thereafter. We began data collection for the aim 2 validation study in December 2022. Initial results from the validation study are expected to be available after December 2025. We hope that G-Date will enhance our understanding of factors associated with SV risk and serve as a useful step in creating prevention programs for this susceptible population.

Understanding the impact of women's correct risk perception on human immunodeficiency virus diagnosis: Insights from South Africa.

South African women have the highest burden of HIV infections globally. We investigated the temporal trends and the impact of key factors associated with HIV diagnosis among a nationally representative cohort of South African women. Total of 24,657 women who participated in the National HIV, Behaviour and Health Surveys conducted from 2002-to-2017. Despite decades-long prevention efforts, we observed a significant increase in HIV prevalence over time (22% in 2002 to 21% in 2005-2008 and 29% in 2012-2017). Overall, 46% of the women living with HIV were not aware of their risk of HIV with age-specific disparities. Our findings revealed compelling evidence between HIV seropositivity and high HIV risk-perception (adjusted Odds Ratio (aOR):1.47 to 3.29) which increased overtime and exceeded the other factors. At a population-level, 45% of the HIV diagnoses were exclusively associated with women who believed they were at risk of HIV in 2012-2017. Women who reported using condoms at last sexual act were also at increased risk of HIV infection, with a population attributable risk of 18% (2002) to 21% (2012-2017). There is an urgent need for culturally, socially, and linguistically appropriate prevention and awareness campaigns with realistic, non-confrontational messages.

The pregnant women's perception of risks and pregnancy stress levels: a cross-sectional study from Turkey.

The aim of this study was to compare pregnant women's perceptions of risk and pregnancy-specific stress levels. This cross-sectional descriptive study was conducted with 410 healthy pregnant women at the city hospital located in the east of Turkey. Data were collected via Personal Information Form, Perception of Pregnancy Risk Questionnaire, and Pregnancy Stress Rating Scale. The pregnancy risk perception mean score was 2.43±1.82, and the pregnancy-specific stress mean score was 22.27±12.67. There is a statistically significant and strong positive correlation between the perception of pregnancy risk and pregnancy-specific stress level (p<0.01). Pregnant women's pregnancy risk perception decreased as the duration of marriage and the number of living children increased, and it increased as the gestational week increased (p<0.05). Pregnancy-specific stress decreased as the duration of marriage (p<0.001), the age of the spouse, the number of pregnancies, and the number of living children increased (p<0.01), and it increased as the gestational week increased (p<0.01). The pregnant women's perceptions of pregnancy risks and pregnancy-specific stress were low, but pregnancy-specific stresses increased as their perceptions of pregnancy risks increased.

Chatbot-interfaced and cognitive-affective barrier-driven messages to improve colposcopy adherence after abnormal Pap test results in underserved urban women: A feasibility pilot study.

Challenges in ensuring adherence to colposcopy and follow-up recommendations, particularly within underserved communities, hinder the delivery of appropriate care. Informed by our established evidence-based program, we sought to assess the feasibility and acceptability of a novel cognitive-affective intervention delivered through a Chatbot interface, aimed to enhance colposcopy adherence within an urban inner-city population. We developed the evidence-based intervention, CervixChat, to address comprehension of colposcopy's purpose, human papillomavirus (HPV) understanding, cancer-related fatalistic beliefs, procedural concerns, and disease progression, offered in both English and Spanish. Females aged 21-65, with colposcopy appointments at an urban OBGYN clinic, were invited to participate. Enrolled patients experienced real-time counseling messages tailored via a Chatbot-driven barriers assessment, dispatched via text one week before their scheduled colposcopy. Cognitive-affective measures were assessed at baseline and through a 1-month follow-up. Participants also engaged in a brief post-intervention satisfaction survey and interview to capture their acceptance and feedback on the intervention. The primary endpoints encompassed study adherence (CervixChat response rate and follow-up survey rate) and self-evaluated intervention acceptability, with predefined feasibility benchmarks of at least 70% adherence and 80% satisfaction. Among 48 eligible women scheduled for colposcopies, 27 (56.3%) agreed, consented, and completed baseline assessments. Participants had an average age of 34 years, with 14 (52%) identifying as non-Hispanic White. Of these, 21 (77.8%) engaged with the CervixChat intervention via mobile phones. Impressively, 26 participants (96.3%) attended their diagnostic colposcopy within the specified timeframe. Moreover, 22 (81.5%) completed the follow-up survey and a brief interview. Barriers assessment revealed notable encodings in the Affect and Values/Goals domains, highlighting concerns and understanding around HPV, as well as its impact on body image and sexual matters. Persistent and relatively high intrusive thoughts and lowered risk perceptions regarding cervical cancer were reported over time, unaffected by the intervention. Post-intervention evaluations documented high satisfaction and perceived usefulness, with recommendations for incorporating additional practical and educational content. Our findings underscore the robust satisfaction and practicality of the CervixChat intervention among a diverse underserved population. Moving forward, our next step involves evaluating the intervention's efficacy through a Sequential Multiple Assignment Randomized Trial (SMART) design. Enhanced by personalized health coaching, we aim to further bolster women's risk perception, address intrusive thoughts, and streamline resources to effectively improve colposcopy screening attendance.

A socioecological description of the influencing factors to midwives' management of preeclampsia in a Ghanaian tertiary hospital.

In low-resource settings, midwives are the first contact for women with preeclampsia and lead the coordination of care. Unfavourable preeclampsia outcomes create a burden for women, families, and the health system. It is therefore important to understand the unique context of midwives' practice and the complex factors that influence the delivery of maternal healthcare. This qualitative study explored the perspectives of key stakeholders in a tertiary hospital in Ghana regarding the facilitators and barriers influencing midwives' provision of preeclampsia care using a socioecological model. Semi-structured interviews were conducted with 42 participants comprising senior managers (n = 7) and hospital midwives (n = 35) in 2021. Thematic analysis used Braun and Clarke's six-step method, and the findings were organised within four levels of the socioecological model: individual, interpersonal, organisational, and public policy. Two main themes were identified: 1) Facilitators of preeclampsia management, and 2) Barriers to preeclampsia management. Facilitators were identified at three levels (individual, interpersonal, and organisational) and included midwives' knowledge of preeclampsia; midwives' self-efficacy; midwives' skillset to enhance preeclampsia care; collaborative practice; and strategies for preeclampsia care quality improvement. At the individual level, the barriers were inadequate pre-service preparation, lack of evidence-based midwifery care, and colleagues' work attitudes. Hierarchical decision-making and staff views of women's risk perceptions were identified as barriers at the interpersonal level. At the organisational level, the barriers were: scarce resources and staff shortages, and a lack of midwifery-specific guidelines. Two barriers were identified within the public policy level: the high cost of preeclampsia care and issues with the referral system. Multi-faceted factors play a significant role in midwives' management of preeclampsia. Hence context-specific multi-level interventions have the potential to improve the quality-of-care women in Ghana receive.

Utilisation of Maternal Health Services During COVID-19 Pandemic: Findings from Rural West Bengal, India

The existing state of health infrastructure and services, which is often poor in rural areas of the country is further faced with challenges due to the COVID-19 pandemic. The current study attempts to provide some key insights on the impact of COVID-19 on utilisation of maternal healthcare services during the pandemic. The study used the mixed-method data, gathered through a cross-sectional study conducted in 2020 in South 24 Parganas district of West Bengal. Currently, married women ( n = 318) who were pregnant or had delivered a child were selected for the interview through a multi-stage sampling technique. Frequency distribution, bi-variate cross tabulation and logistic regression were performed. Of the eligible women during the pandemic, 86% have received regular antenatal care, 73% have delivered in a health facility even though the quality of service was poor; and only 37.6% received postnatal care within 42 days of delivery. ‘Risk perception of women towards being infected with COVID-19’ were found to be the most significant determinants of maternal healthcare utilisation. COVID-19 pandemic has significantly affected the quality and utilisation of maternal health services in rural West Bengal. The results suggest the need for better preparedness of healthcare facilities in terms of human resources and physical infrastructure; as well as educating the community through awareness (counter rumours) and through risk and behaviour change communication regarding COVID-19 protocols and community engagement to effectively manage utilisation of Maternal healthcare services during pandemic.

HIV risk perception, pre-exposure prophylaxis (PrEP) awareness, and PrEP initiation intention among women who use drugs

IntroductionWomen who use drugs (WWUD) are prime candidates for pre-exposure prophylaxis (PrEP) due to their elevated risk of acquiring HIV through biological, behavioral, and contextual factors. However, PrEP uptake among WWUD remains low. The relationship between unhealthy drug use and correlates of PrEP uptake in this vulnerable population is not well defined. The purpose of this study is to characterize the relationships between specific types and routes of drug use and several precursors of PrEP uptake among WWUD. MethodsThe study collected data via a computer-based survey from 233 women living in New York City and Philadelphia who participated in a study designed to develop and pilot a women-focused intervention for PrEP uptake. The sample of cisgender, HIV-negative women were not currently taking PrEP but considered PrEP eligible. This analysis is focused on women's HIV risk perception, PrEP awareness, PrEP initiation intention, and any use of the following drugs: barbiturates, benzodiazepines, crack cocaine, powder cocaine, hallucinogens, heroin, methamphetamines, and prescription opioids. ResultsWithin the three months prior to study enrollment, 63.1 % of participants reported any drug use; 42 % reported polydrug use; 19.8 % had injected drugs; 75 % reported getting high or drunk before sex; and 44 % had been enrolled in drug treatment. Of our total sample, 41.2 % perceived themselves at risk for HIV infection, 41.6 % were aware of PrEP prior to the study, and 62.7 % intended to initiate PrEP after they were informed. When compared to other PrEP-eligible women, women who reported prescription opioid use and polydrug use perceived themselves at higher risk for HIV infection and had higher intention to start PrEP. However, they and women who reported injecting drugs also reported lower awareness of PrEP. ConclusionThese findings have implications for increasing education about PrEP and the various modes of HIV exposure to support PrEP uptake in this vulnerable population.

Interrogating the pill: Rising distrust and the reshaping of health risk perceptions in the social media age

Since its introduction in 1960, the combined oral contraceptive pill has become the dominant reversible contraceptive technology for controlling female fertility in spite of early and ongoing ethical, critical medical, and societal disapproval. Over the last decade, prescription rates among young women in Western Europe have declined alongside the rise of social media use. This article investigates the mechanisms underlying this change in contraceptive choices and the role played by social media in this trend. Via exploratory online observation and an in-depth interview study with 19 informants in Germany and Denmark, we find social media consolidates the social construction of hazards associated with the contraceptive pill by reshaping young women's risk perception from questions around drug reliability and safety to those of individual physical, mental, and social well-being. We shed light on how social media contributes to the delegitimation of health professionals such as gynaecologists and general practitioners and adds to wider debates on the erosion of medical authority and the attendant rise of peer influencers. We condense our findings into a framework for health-related attitude formation and decision-making in the social media age, which elucidates how social media amplifies and reshapes societal discourses regarding health-related technologies, choices, and risks.

Testing Theory-Based Messages to Encourage Women at Average Risk for Breast Cancer to Consider Biennial Mammography Screening.

The US Preventive Services Task Force does not recommend routine annual mammography screening for women aged 40-49 at average risk. Little research has been done to develop theory-based communication interventions to facilitate informed decision-making about reducing potentially low-value mammography screening. Evaluate the effects of theory-based persuasive messages on women's willingness to consider delaying screening mammography until age 50 or have mammograms biennially. We conducted a randomized controlled communication experiment online with a population-based sample of U.S. women aged 40-49 (N = 383) who screened to be at average risk for breast cancer. Women were randomly assigned to the following messaging summaries: annual mammography risks in 40s (Arm 1, n = 124), mammography risks plus family history-based genetic risk (Arm 2, n = 120), and mammography risks, genetic risk, and behavioral alternatives (Arm 3, n = 139). Willingness to delay screening or reduce screening frequency was assessed post-experiment by a set of 5-point Likert scale items. Women in Arm 3 reported significantly greater willingness to delay screening mammography until age 50 (mean = 0.23, SD = 1.26) compared with those in Arm 1 (mean = -0.17, SD = 1.20; p = .04). There were no significant arm differences in willingness to reduce screening frequency. Exposure to the communication messages significantly shifted women's breast cancer-related risk perceptions without increasing unwarranted cancer worry across all three arms. Providing women with screening information and options may help initiate challenging discussions with providers about potentially low-value screening.

IDF2022-0900 Diabetes Risk Perception in Women with previous Gestational Diabetes – analysis of a multi-ethnic cohort

IDF2022-0900 Diabetes Risk Perception in Women with previous Gestational Diabetes – analysis of a multi-ethnic cohort

Gendered Economy: Sociality and the Lesbian Consumer Market in China1

The gay consumer market is often treated as a homogeneous entity, and Anglophone scholarship has given scant attention to lesbian consumers. This paper examines gendered distinctions within the Chinese gay market by asking how the lesbian consumer market is organized differently from its gay male counterpart and why some types of businesses thriving in the gay male market are likely to fail in the lesbian market. Based on interviews with entrepreneurs and business professionals, supplemented with ethnographic and media data, this study indicates that certain types of commerce existing in the gay male consumer market do not dovetail with lesbians' preferred ways of socializing associated with women's risk perception. Unlike previous scholarship that simply characterized the lesbian market as “underdeveloped,” this research demonstrates that opportunities for the lesbian and gay male markets exist in different types of trade and business. Although the concept of the pink economy is theoretically grounded in sexual orientation, China's pink market demonstrates how gender plays a key role in shaping the lesbian consumer market.

A Survey of the Effect of Risk Perception and Socioeconomic Status on Coping Strategies in Violent Situations Against Women

Objective: Violence against women is a severe mental health problem. Much research has been done separately on the perception of risk, socioeconomic status (SES), and coping strategies of women who are victims of domestic violence. This study aims to investigate how women's risk perception and socioeconomic status affect their choice of coping strategies and to compare women who are victims of violence with women who have not experienced domestic violence. Method: The statistical population is married women in Iran, 312 women were selected as a sample through random sampling. To measure the variables, four questionnaires were used: Ghodratnama's Socioeconomic Status (SES), Haj-Yahia's Questionnaire of Violence Against Women, Benthin Risk Perception Scale, and Jalowiec Coping Scale. After the data collection stage, the relationship between the variables was analyzed using SPSS software and Pearson's correlation and linear regression. Results: In women victims of violence, risk perception was significantly related to fatalistic and palliative strategies, and SES was significantly related to evasive strategy (p&lt;0.05). In women who were not subjected to domestic violence, risk perception had a significant relationship with optimistic, fatalistic, and emotive strategies (p&lt;0.05). The correlation coefficient between risk perception and fatalistic and emotive strategy was very weak and can be ignored. Conclusion: The present study showed that the perception of risk affects the fatalistic and palliative coping strategies of women who are victims of violence, and their low socioeconomic status leads to more use of passive strategies such as evasive. And women who have not experienced domestic violence, the less they see themselves in danger of violence, the more they will use optimistic strategies.

COVID-19-related attitude and risk perception among pregnant women attending antenatal care, and the associated factors, at public health facilities of East Gojjam Zone, Ethiopia, 2020: a multi-center cross-sectional study.

This study aimed to assess COVID-19 (coronavirus disease 2019)-related attitude and risk perception among pregnant women attending antenatal care, and the associated factors, at public health facilities of the East Gojjam Zone, Ethiopia. A multi-center cross-sectional study was conducted, from December 1-30, 2020. A total of 847 pregnant women were included in the study using a simple random sampling technique. To collect the data, we used an interviewer-administered questionnaire. Bi-variable and multi-variable logistic regression analyses were used to identify factors associated with pregnancy-related anxiety. A p-value of <0.05 with a 95% confidence level was used to declare statistical significance. The magnitude of COVID-19-related positive attitude and high-level risk perception among pregnant women was 51.12% and 37.2% respectively. Having adequate knowledge [AOR: 2.09, 95% CI= (1.49-2.95)], ≥3 ANC visits [AOR: 1.43, 95% CI=1.0-1.98], and a low level of risk perception [AOR: 6.27, 95% CI= (4.42-8.89)] were factors associated with a positive attitude of pregnant women with regard to the COVID-19 pandemic. Being urban residents [AOR: 2.24, 95% CI: 1.6-3.10], having wanted pregnancy [AOR: 3.35, 95% CI: 1.18-9.49], having a negative attitude [AOR: 6.21, 95% CI: 4.43-8.70], and a complicated pregnancy [AOR: 1.67, 95% CI: 1.02--2.75] were factors significantly associated with risk perception of pregnant women with regard to the COVID-19 pandemic. Despite its high fatality, COVID-19 pandemic-related attitude and risk perception among pregnant women were low. As a result, health caregivers and other concerned bodies should consider interventions to improve pregnant women's risk perception and attitude during antenatal care and through various community information platforms. The online version contains supplementary material available at 10.1007/s10389-022-01797-x.

남성 화장품 관련 연구 동향 분석을 통한 코로나19 펜데믹 이후 소비시장 변화 대응 방안

This study analyzes the research trends related to male cosmetics conducted from 2000 to 2022. The purpose is to suggest countermeasures in the men's cosmetics market in the future based on changes in the consumer market brought by the COVID-19 pandemic. Among a total of 230 papers on men's cosmetics from 2000 to 2022, 39 papers, excluding 191 papers that are not provided online, papers that are not related to the subject of this study, and papers extracted in duplicate, were collected. While analyzing the paper, women's risk perception and changes in the cosmetics consumption culture are frequently discussed, studies on men's risk perception and cosmetics consumption patterns are insufficient. As a result of the analysis, the cosmetics market is changing from offline to online, and the proportion of online distribution channels is expected to increase rapidly due to COVID-19, so it is required to revitalize the cosmetics industry through online channel diversification. In addition, it is required to develop functional cosmetics and provide information so that men can manage their appearance more easily by providing information on men's skin types and identifying the motives and purposes of men's appearance management behavior.

Gender bias in the primary prevention of cardiovascular disease

Abstract Funding Acknowledgements Type of funding sources: None. Background/introduction Women receive less aggressive treatment for cardiovascular disease (CVD), partly due to a delayed or incorrect diagnosis. However, there is little research into whether this gender bias extends to primary prevention of CVD (i.e. prevention of CVD in those individuals with no prior CVD events), and the reasons behind this bias. Purpose This study analysed gender differences in the primary prevention of CVD in the USA, using data from the National Health and Nutrition Examination Survey (NHANES) for the years 2015-2018. It also explored the drivers behind these differences. The hypothesis was that the known gender bias in CVD treatment also extends to primary prevention. Methods The risk of developing CVD over the next ten years was calculated using the Pooled Cohort Equations (PCEs) for 9,623 healthy men and women aged 40 to 79 years. 3,035 participants were found to be at higher CVD risk (ASCVD score above 7.5%) and potentially eligible for statins. Individuals with prior diagnosis of CVD were excluded from this study. Multivariable logistic regression was used to calculate adjusted odds ratios (AOR) in the usage of preventive treatment between genders. Results The results showed that men were 21% more likely to be prescribed statins than women whilst women were 20-37% more likely to be told to make behaviour modifications than men (Table 1). An interdisciplinary literature review showed that lower CVD risk perception in women is a likely driver of this gender difference. Conclusion The well-known gender bias in the treatment of CVD also appears to take place in the primary prevention of CVD with statin therapy. These findings have highlighted the gender bias in primary prevention of CVD, supporting the scarce existing literature on this topic and providing more recent evidence in line with the updated CVD prevention guidance. This has implications in developing interventions based in the health system and community context to improve the treatment and survival outcomes for women with CVD.

MO1044: Understanding Perception of Pregnancy Risk in Women with Chronic Kidney Disease

BACKGROUND AND AIMSWomen with chronic kidney disease (CKD) are at increased risk of adverse pregnancy and renal outcomes, including preterm birth and progression of kidney disease. Women's risk perceptions of pregnancy impact behaviours and decisions including engagement with prenatal care, mode of delivery choices and adherence to medical advice, therefore, it is important that women perceive and understand their risk accurately. Pre-pregnancy counselling is recommended for all women with CKD, but it is unknown how women with CKD understand their pregnancy risk and if pre-pregnancy counselling affects women's perceptions. The aim of this study was to understand how a large cohort of diverse women with CKD perceive their pregnancy risk and compare differences in risk perceptions between those who have and have not received pre-pregnancy counselling.METHODThe ‘Perception of Pregnancy Risk Questionnaire’ (PPRQ;1) and ‘Desire to Avoid Pregnancy Questionnaire’ (2) were used to measure risk perception and pregnancy intention respectively. The PPRQ was adapted to assess risk perceptions in women with CKD including the severity of kidney disease. Content validity of the adapted PPRQ was confirmed by a panel of 21 experts including nephrologists, midwives, psychologists and obstetricians. Women aged between 18 and 50 years with CKD stages 1–5 were recruited from nine renal units in the United Kingdom and asked to complete an online survey (October 2020–December 2021). Clinical data were extracted from local databases. Data were analysed descriptively.RESULTSA total of 322 women completed the survey, mean age of 34.9 (SD 7.1) years. Women's obstetric history and pregnancy perspectives are described in the Table. Half of the respondents already had children (172/322; 54.1%) and three-quarters perceived pregnancy to be important or very important to themselves (241/322; 75.8%) and two-thirds (218/322; 66.7%) perceived pregnancy to be important or very important to their family. Only 109/321 (34%) of women with CKD had previously attended pre-pregnancy counselling, but those who had attended had a higher perception of pregnancy risk [51.4 (SD 21.4) versus 41.9 (SD 23.8); P < 0.0001] (0: not very severe to 100: extremely severe) and severity of kidney disease [51.3 (SD 24.9) versus 43.7 (SD 28.6); P = 0.014] compared to women who had not attended pre-pregnancy counselling.CONCLUSIONThis large multi-centre questionnaire study identified that risk perceptions of pregnancy for women with CKD appear to be higher than those of women with an uncomplicated pregnancy [PPRQ scores of 24.0 (SD 14.5)] [1]. However, women who had received pre-pregnancy counselling had a significantly higher perception of pregnancy risk and perceived severity of kidney disease. Limitations include a lack of measurement before and after attending a pre-pregnancy counselling clinic. Further assessment of the relationship between severity of kidney disease and perceived pregnancy risk and pregnancy intentions is needed.Table 1.Comparison by awareness of influenza vaccinationNot aware of influenza vaccine N = 21Aware of influenza vaccine N = 65 P-valueClinic respondents, n (%)Telephone respondents, n (%)7 (33.3)14 (66.7)38 (58.5)27 (41.5)0.045Age at screening, years53.2 (40.1, 59.0)39.2 (30.6, 52.6)0.02Male, n (%)8 (38.1)25 (38.5)0.98English spoken at home, n (%)7 (33.3)43 (66.2)0.008English spoken at healthcare, n (%)16 (76.2)62 (95.3)0.03Secondary school education or below, n (%)11 (52.4)14 (21.5)0.007Professional or executive, n (%)6 (28.6)37 (56.9)0.02Income above $2000/month, n (%)10 (55.6)48 (84.2)0.02Disease duration, months33 (15, 53)40 (19, 59)0.43Aware of COVID-19 vaccine, n (%)21 (100)65 (100)-Received COVID-19 vaccine, n (%)20 (95.2)52 (80.0)0.17Health literacy index32.6 (30.1, 38.5)33.3 (30.5, 38.6)0.72Categorical variables were presented as number (percentage) and compared using the Pearson chi-squared or Fisher's exact test as appropriate. Continuous variables were presented as medians with interquartile ranges [IQR (25th percentile, 75th percentile)] and compared using the Mann–Whitney U test. P-values < 0.05 were considered statistically significant.Table 2.Factors associated with influenza vaccine awareness after adjusting for survey typeAdjusted Odds Ratio95% Confidence Interval P-valueAge at screening, per 1 year increase0.950.92–0.990.02Male compared to female1.030.36–2.910.96English spoken at home, yes3.191.07–9.470.04English spoken at healthcare, yes8.871.70–46.370.01Secondary school education or below, yes0.230.08–0.680.008Professional or executive, yes3.361.20–10.930.02Income above $2000/month, yes4.031.19–16.630.03Disease duration, per 1 month increase1.010.98–1.030.63Received COVID-19 vaccine, yes3.340.38–29.470.28Health literacy index, per unit increase0.950.86–1.060.35

Positive impact of a co-designed digital resource for women with early menopause.

To evaluate a co-designed early menopause digital resource, including audio/video clips, question prompt list, and information links. Pre/post-test study. Women with early menopause, defined as menopause before age 45 years, were recruited from the community. Following online informed consent, participants were emailed links to the digital resource and online surveys to complete before (baseline) and, immediately and 1 month after viewing the resource. Main outcome measures: Health-related empowerment (Health Education Impact Questionnaire), illness perception (Brief Illness Perception Questionnaire), menopause symptoms (Greene Climacteric Scale), risk perception, and knowledge change. One hundred fifty women participated. Compared to baseline, at 1-month health-related empowerment, 'health directed behavior' scores increased (mean change: +0.13; 95% CI: 0.01-0.24; and P = 0.03), 'emotional distress' decreased (mean change: -0.15; 95% CI: -0.25 to -0.05; and P = 0.003) and physical and emotional menopause symptom scores decreased (P = 0.001 and P = 0.02, respectively). Illness perception scores increased at both immediate and 1-month follow-up versus baseline for 'personal control' (P < 0.001 and P = 0.02) and 'coherence' (P = 0.003 and P < 0.001). After viewing the digital resource, more women perceived that hormone therapy decreases heart disease risk, reduces hot flashes, and prevents fractures versus baseline (all P < 0.05). More women correctly answered questions regarding early menopause prevalence (60% vs 35%), cause (46% vs 33%), risk (76% vs 55%), effect of phytoestrogens (60% vs 27%), and osteoporosis prevention (64% vs 44%) at immediate or 1-month follow-up versus baseline (all P < 0.05). A co-designed early menopause digital resource may improve women's health-related empowerment, illness perception, menopause symptoms, risk perception, and knowledge.