Epidemiologic insight into Trinidad’s awareness and prevention of heart disease. The EPITAPH study - a trinidadian cardiovascular health literacy survey
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20171305Keywords:
Cardiovascular disease, Cardiovascular knowledge, Cardiovascular health literacy, Epidemiology, Trinidad & TobagoAbstract
Background: The aim of the study is to assess the degree of CV health literacy in the Trinidadian public health sector and to identify any factors associated with it.
Methods: The descriptive, cross-sectional study was conducted at a single, public health care tertiary hospital, cardiology outpatient clinic located in northern-central Trinidad. Participants: A total of 420 persons were approached, of whom, 390 agreed to participate. Participants included all sexes and ethnicities. The study only excluded patients who declined participation and those younger than 18 years of age. Primary and secondary outcome measures: The primary endpoints were the mean score and percentage of correctly answered items, and percentages of modest and high levels of knowledge. Secondary endpoints were the proportion of participants with tertiary or above level education.
Results: The study had a response rate of approximately 93%. The domain of “risk factors” had the most correct responses (69.4%), whereas “medical knowledge” reflected the least correct (57.7%) responses. The overall mean score was 19.7 out of the 30-question questionnaire. This translated to a 65.8% correct response rate. The percentage of participants who scored less than 70% and greater than 70% of the questions correctly were 56.2% and 43.8% respectively. The study participants were found to be more knowledgeable about CVD if they reported “tertiary education,” OR 2.572 (95% CI 1.508-4.387) (p = .001).
Conclusions: Respondents displayed a modest level of knowledge and key deficiencies were identified which could potentially translate into suboptimal CV clinical outcomes. The study underscores the paramount importance of establishing comprehensive educational interventions to improve overall CVD literacy in Trinidad and Tobago. Further studies are required to confirm and validate these findings.
References
Robson J. Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. Heart. 2008 ;94(10):1331–2.
Bhatia SK. Biomaterials for Clinical Applications. 2010.
Kones R. Primary prevention of coronary heart disease: integration of new data, evolving views, revised goals, and role of rosuvastatin in management. A comprehensive survey. Drug Des Devel Ther. 2011;5:325–80.
Johnson NB, Hayes LD, Brown K, Hoo EC, Ethier KA, Centers for Disease Control and Prevention (CDC). CDC National Health Report: leading causes of morbidity and mortality and associated behavioral risk and protective factors--United States, 2005-2013. MMWR Surveill Summ. 2014;63(4):3–27.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163–96.
WHO | Cardiovascular diseases (CVDs). Website . Available from http://www.who.int/mediacentre/
factsheets/fs317/en/. Accessed on 4 February 2017.
WHO | Cardiovascular diseases (CVDs). 2016 Feb 2. Available from: http://www.who.int/
mediacentre/factsheets/fs317/en/. Accessed on 4 February 2017.
Ezzati M. Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. 2004: 2248.
Agency CI. The CIA World Factbook 2016. Skyhorse Publishing, Inc. 2015: 976.
Miller GJ, Beckles GLA, Maude GH, Carson DC, Alexis SD, Price SGL, et al. Ethnicity and Other Characteristics Predictive of Coronary Heart Disease in a Developing Community: Principal Results of the St James Survey, Trinidad. Int J Epidemiol. 1989;18(4):808–17.
Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation. 2001;104(23):2855–64.
PAHO Health in the Americas. Available from: http://www.paho.org/saludenlasamericas/index.php?option=com_docman&task=doc_view&gid=149&Itemid. Accessed on 7 February 2017.
Awad A, Abdelmoneim A, Hala A-N. Public knowledge of cardiovascular disease and its risk factors in Kuwait: a cross-sectional survey. BMC Public Health. 2014;14(1):1131.
Vaidya A, Aryal UR, Krettek A. Cardiovascular health knowledge, attitude and practice/behaviour in an urbanising community of Nepal: a population-based cross-sectional study from Jhaukhel-Duwakot Health Demographic Surveillance Site. BMJ Open. 2013;3(10):002976.
Manley AF. Physical Activity and Health: A Report of the Surgeon General. DIANE Publishing. 1996: 278.
Mckinley S, S M. International comparison of factors associated with delay in presentation for AMI treatment. Eur J Cardiovasc Nurs. 2004;3(3):225–30.
Sug Yoon S, Heller RF, Levi C, Wiggers J, Fitzgerald PE. Knowledge of Stroke Risk Factors, Warning Symptoms, and Treatment Among an Australian Urban Population. Stroke. 2001;32(8):1926–30.
Jafary FH, Aslam F, Mahmud H, Waheed A, Shakir M, Afzal A, et al. Cardiovascular health knowledge and behavior in patient attendants at four tertiary care hospitals in Pakistan--a cause for concern. BMC Public Health. 2005;5:124.
Authors/Task Force Members:, Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, et al. “European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)” The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2012;33(17):2126.
Al Hamarneh YN, Crealey GE, McElnay JC. Coronary heart disease: health knowledge and behaviour. Int J Clin Pharm. 2011;33(1):111–23.
Pearson TA, Palaniappan LP, Artinian NT, Carnethon MR, Criqui MH, Daniels SR, et al. American Heart Association Guide for Improving Cardiovascular Health at the Community Level, 2013 Update: A Scientific Statement for Public Health Practitioners, Healthcare Providers, and Health Policy Makers. Circulation. 2013;127(16):1730–53.
Jafary FH, Fawad A, Hussain M, Abdul W, Murtaza S, Atif A, et al. Cardiovascular health knowledge and behavior in patient attendants at four tertiary care hospitals in Pakistan – a cause for concern. BMC Public Health. 2005;5(1).
Agency CI. The CIA World Factbook 2016. Available from https://www.cia.gov/library/
publications/the-world-factbook/geos/print/country/
countrypdf_td.pdf. Accessed on 1 February 2017.
Bergman HE, Reeve BB, Moser RP, Sarah S, Klein WMP. Development of a Comprehensive Heart Disease Knowledge Questionnaire. Am J Health Educ. 2011;42(2):74–87.
Leventhal H, Howard L. Findings and Theory in the Study of Fear Communications. In: Advances in Experimental Social Psychology. 1970: 119–86.
Leventhal H, Howard L, Michael D. The Active Side of Illness Cognition. In: Contributions to Psychology and Medicine. 1991:247–72.
Avis NE, Smith KW, McKinlay JB. Accuracy of perceptions of heart attack risk: what influences perceptions and can they be changed? Am J Public Health. 1989;79(12):1608–12.
Khan MS, Jafary FH, Faruqui AM, Rasool SI, Juanita H, Nish C, et al. High prevalence of lack of knowledge of symptoms of acute myocardial infarction in Pakistan and its contribution to delayed presentation to the hospital. BMC Public Health. 2007;7(1):284.
Mukattash TL, Mohd S, Jarab AS, Al-Azzam SI, Ammar A, Al Hamarneh YN. Public knowledge and awareness of cardiovascular disease and its risk factors: a cross-sectional study of 1000 Jordanians. Int J Pharm Pract. 2012;20(6):367–76.
White CW, Albanese MA. Changes in cardiovascular health knowledge occurring from childhood to adulthood. A cross-sectional study. Circulation. 1981;63(5):1110–5.