Risk perception of cardiovascular disease among Turkish adults: a cross-sectional study

Barriers and facilitators of complications risk perception among rural patients with type 2 diabetes mellitus: a qualitative content analysis

BACKGROUND

Diabetes and its complications have emerged as a significant health threat to rural residents. Accurately perceiving the risk of complications may play a crucial role in modifying health behaviors and preventing complications' occurrence. We aimed to explore the barriers to and facilitators of risk perception of complications in rural patients with type 2 diabetes mellitus, and to provide new perspectives and ideas for the development of relevant interventions in the future.

METHODS

This study adopted the qualitative content analysis method. Semi-structured interviews were conducted with 14 rural diabetic patients selected by purposive sampling from July to September 2023, and the interview data were systematically analyzed.

RESULTS

Data analysis identified 9 sub-themes falling into the 2 macro-themes: (a) facilitators of complications risk perception (Increased disease knowledge, Low sense of disease control, Risk experiences, Negative mindset); (b) barriers to complications risk perception (Lack of awareness of diabetes or its complications, Information barriers, Optimistic bias, Overconfidence, Disease generalization).

CONCLUSIONS

This study explored the barriers and facilitators of complication risk perception among rural patients with type 2 diabetes mellitus, offering new insights into risk perception research, and aiding primary medical staff to develop targeted intervention measures to ensure that rural diabetes patients can accurately and objectively perceive risk.

Cardiovascular disease risk perception among community-dwelling adults in southwest Nigeria: A mixed-method study

OBJECTIVE

The rising prevalence of cardiovascular diseases (CVD) remains a global concern. In Nigeria, the current prevalence of CVD was 76.11% with its attendance burden. The CVD risk perception of individuals is a precursor to the desired lifestyle modification necessary for CVD prevention and management. This study assessed the CVD risk perception and sociodemographic determinants among rural and urban dwellers in southwest Nigeria.

METHODS

The study employed a convergent parallel mixed-methods design involving concurrent data collection. The participants' CVD risk perception was obtained using the Perception of Risk of Heart Disease Scale (quantitative data) and a validated focus group discussion (FGD) guide (qualitative data). Quantitative analysis was completed using descriptive statistics, Phi, Cramer's V, and multivariate linear regression, while the FGD was thematically analysed.

RESULTS

The quantitative study involved 1,493 participants (62.4% women) with a mean age of 46.90±15.65 years, while the FGD involved 53 participants (52.8% women) with a mean age of 50.10±13.5 years. Over a quarter (28%) of the participants had a poor CVD risk perception; the mean score was 44.40±8.07. Rural residents had a significantly poorer CVD risk perception than their urban counterparts (Mean difference = -3.16, p<0.001). Having tertiary education (β = 0.100, p < 0.001), living in urban areas (β = 0.174, p<0.001), and living in Lagos (β = 0.074, p = 0.013) and in Oyo, other than Ogun state (β = -0.156, p<0.001) significantly predicted having a good perception of CVD risk. FGD produced three themes: knowledge about CVD, CVD risk factors, and CVD prevention.

CONCLUSION

Participants had a fair understanding of the causes and prevention of CVD. Yet, a substantial portion underestimated their own risk of developing CVD, particularly rural dwellers and people with lower education. More public health education is required to improve the CVD risk perception in southwestern Nigeria.

Triglyceride and Glucose Index as an Optimal Predictor of Metabolic Syndrome in Lebanese Adults

Background: Globally, the prevalence of metabolic syndrome (MetS) is on the rise, especially in Arab countries, which emphasizes the need for reliable ethnic-specific biochemical screening parameters. Methods: Two hundred twenty-one Lebanese adults were enrolled in this cross-sectional study. Biochemical parameters including Homeostasis Model Assessment (HOMA), Triglyceride and Glucose index (TyG), ratio of Triglycerides to High-Density Lipoprotein Cholesterol (TG/HDL-C), Atherogenic Index of Plasma (AIP), and Visceral Adiposity Index (VAI) were assessed for their prediction of MetS. Analysis of covariance, logistic regression, expected-versus-observed case ratio were used to determine model calibration, concordance statistic, area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs), sensitivity, specificity, and negative and positive predictive values (PPV, NPV). Results: The prevalence of MetS was 44.3%. All biochemical parameters were significantly associated with MetS, with a strong model discrimination (c-statistic between 0.77 and 0.94). In both sex categories, TyG best predicted MetS (females: cut-off value, 8.34; males: cut-off value, 8.43) and showed good estimation among females, but overestimation among males. HOMA had the lowest discriminatory power in both sex categories. Conclusions: This study suggests that TyG best predicts MetS, while HOMA has the lowest predictive power. Future larger studies need to focus on harmonizing ethnic specific cut-offs and further validating our results.

Development and validation of the sarcopenia disease risk perception scale for older adults

BACKGROUND

Sarcopenia represents a constant threat to the health of older adults, and accurate risk perception is essential for disease prevention and control. However, current methodologies lack rigorously validated instruments to assess the perceived risk of sarcopenia among this group. Thus, this study aimed to develop and validate a sarcopenia disease risk perception scale for older adults.

DESIGN

The study was conducted in two phases: development of the initial scale and its psychometric evaluation. A STROBE checklist was employed.

METHODS

Based on the two-factor model of risk perception theory and the health belief model, the initial draft of the scale was created through literature review, expert consultations, and a preliminary survey with a small sample. Then, we used a cross-sectional study methodology to conveniently select 438 Chinese older adults. Item analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were used to refine and validate the scale items. Internal consistency and external consistency were assessed to confirm the scale's reliability.

RESULTS

These evaluations established the scale's framework: content validity, item analysis, and EFA. The two factors extracted from the initial analysis explained 62.250% of the observation variance. The CFA confirmed a good fit for the model, demonstrating the scale's robust reliability and validity. The finalized scale includes 15 items and two dimensions: perceived susceptibility (eight items) and perceived severity (seven items).

CONCLUSION

The Sarcopenia Disease Risk Perception Scale for Older Adults is reliable and valid, making it appropriate for assessing the risk perception level in the target population.

Effects of the Omaha System- and HeartScore®-Based Impaired-Risk Perception Reduction Program on the Risk Perception of Individuals Aged 50-65 Years: A One-Group Pre-Test-Post-Test Study

PURPOSE

This study evaluates the impact of interventions in the Omaha System and HeartScore®-based program to reduce impaired-risk perception.

DESIGN

and setting: This study utilized a one-group pre-test-post-test design.

SUBJECTS

The program was conducted among participants aged over 50 years from different social settings.

INTERVENTION

The program had three parts: a briefing on HeartScore® recommendations, Omaha System interventions, and referral to a doctor.

MEASURES

HeartScore® determined cardiovascular disease (CVD) risk, body mass index (BMI) was calculated from height and weight, and the International PA Questionnaire evaluated physical activity (PA) levels. Self-assessment was used to perceived CVD risk, BMI, and PA.

ANALYSIS

We used the Wilcoxon signed-rank test to compare the pre-test and post-test scores of the Omaha System, the problem rating scale (PRS) subscales and McNemar test to measure changes in CVD risk perception, BMI, and PA level.

RESULTS

310 high-risk individuals out of 522 had impaired perception of their CVD risk. Only 201 responded to follow-up phone calls. Interventions based on HeartScore® and Omaha System improved CVD risk and PA perceptions (P < .001) but not BMI. The program significantly increased knowledge, status, and behavior scores (P < .001). After participating, 39% saw a cardiologist, and 57.2% saw a family physician within six months to reduce impaired risk perception. CVD risk perception increased to the actual level after the intervention, mostly in the group with low education level.

CONCLUSIONS

The program using the Omaha System and HeartScore® can help middle-aged individuals better understand their risk of cardiovascular disease.