Prevention of Heart Failure in Women with Disparities.

Purpose

There is a need to examine genderized societal roles in women for reasons for gaps in physical activity levels to create community engaged action models to address these factors with the primary goal of decreasing all cause cardiovascular disease. The purpose of this study was to examine sociodemographic, contextual, system-related, and personal factors contributing to physical activity levels in women at risk through a community engaged approach

Background

Cardiovascular disease remains the leading cause of death across the population. Black and Hispanic women have persistently high CVD risk factors with all cause CVD highest in Black women. Heart failure which is an end result of many cardiovascular diseases is 19% higher in the Black population than the white population. One way to decrease the risk of cardiovascular disease is through physical activity. 24.3% of adults meet physical activity guidelines. Women, particularly those with economic, educational, and access disparities report the lowest levels of physical activity.

Methods

Focus groups were utilized to interview nine adult female community members in an area of high diversity and potential for sociodemographic disparities. Community stakeholders were recruited, hired, and trained by the PI to lead focus groups and analyze data. Semi-structured interviews were used to discuss facilitators, barriers, preferences, and perspectives related to physical activity in the context of participants’ lifestyle. The research team analyzed and coded the transcripts and identified themes contributing to physical activity. Lincoln and Guba's criteria were applied for rigor.

Results

Themes identified barriers to physical activity including access (cost, location, programming, community events, and safety), family factors (childcare), and discomfort with exercising in mixed gender environments. Genderized roles in family management were apparent with strong themes of prioritization of family needs over self, planning self-care around and after family needs, and lack of time related to these priorities. Difficulty with self-regulation, goal setting, and planning related to physical activity. There was lack of knowledge regarding purposes of physical activity in that participants felt more influenced by societal pressures of “ideal image” for women vs a goal of personal health promotion. Social support was a strong facilitator.

Conclusion

Themes indicated barriers particular to gender and socioeconomics that are consistent with high rates of cardiovascular risk in this population. Programming must be initiated to specifically address the needs identified by the participants in the study in order to increase physical activity, decrease risk factors and disease incidence, thus decreasing incidence of heart failure in the population.