Skip to main content
eScholarship
Open Access Publications from the University of California

Scholarly Works (3 results)

  • Thesis
  • Peer Reviewed
UCLA Electronic Theses and Dissertations (2023)

Background. Cardiovascular disease (CVD) risk factors have increased in young and middle-aged women. Assessing awareness, knowledge, and perceptions of CVD among younger women, and how these factors relate to stage of behavior change, are critical to primary prevention. Aims. (1) Conduct a systematic review of the awareness, knowledge, and perceptions of risk factors for CVD among young to middle-aged women. (2) Examine whether race/ethnicity and age were significantly associated with awareness, knowledge, and perceptions of CVD after adjusting for potential confounding factors. (3) Describe the relationship between stage of behavior change and awareness, knowledge, and perceptions of CVD. Methods. PubMed, Cumulated Index to Allied Health and Nursing Literature (CINAHL), Embase, and Web of Science were searched for relevant studies. Women ages 25-55 living in the United States without a self-reported CVD history were recruited for a cross sectional, descriptive study. Awareness was measured with the question, “What is the leading cause of death for women in the United States?” Knowledge, perceptions, and stage of behavior change were measured with the Heart Disease Fact Questionnaire, Health Beliefs Related to CVD, and the Precaution Adoption Process Model questionnaires, respectively. Results. A review of articles yielded six eligible articles. Younger age was linked to lower awareness and women perceived their knowledge of and susceptibility to CVD as low. 149 women were recruited for the study (mean=37.157.86 years). Women had a high level of awareness and knowledge of CVD. Non-Hispanic white women had higher knowledge (HDFQ= 23.271.72 vs. 22.352.50, p=0.011) and lower susceptibility (9.862.75 vs 11.483.53, p=0.003) compared to racial/ethnic minority women. A binary logistic regression of stage of behavior change on awareness, knowledge, and perceptions of CVD showed that the perception subscales of susceptibility and severity were significantly associated with stage of behavior change (OR 1.247, p<0.001 and OR .809, p=.004 respectively), and remained significant when controlling for covariates (OR 1.242, p=.002 and OR=.801, p=.004, respectively) Conclusions. In this sample of well educated, younger and predominately minority women, awareness and knowledge were high. The racial/ethnic minority women believed they more susceptible to CVD. Susceptibility and severity were associated with intent to change behavior.

    Cover page: Awareness, Knowledge, and Perceptions of Cardiovascular Disease among Adult Women Ages 25-55
    • Article
    • Peer Reviewed
    UCLA Previously Published Works (2022)

    Purpose

    Stable angina is ischemic chest pain on exertion or with emotional stress. Despite guideline-directed therapy, up to 30% of patients have suboptimal pain relief. The aims of this study were to: (1) determine the feasibility and acceptability of a randomized controlled trial (RCT) of acupuncture; and (2) evaluate preliminary efficacy of acupuncture with respect to reduction of pain and increased functional status and health-related quality of life (HRQoL).

    Methods

    Participants with stable angina for ⩾1 month received either a standardized acupuncture protocol, twice per week for 5 weeks, or an attention control protocol. Measures included the McGill Pain Questionnaire (average pain intensity (API), pain now) and the Seattle Angina Questionnaire-7 (functional status, symptoms, and HRQoL). Feasibility was defined as ⩾80% recruitment, ⩾75% retention following enrollment, and ⩾80% completion. Descriptive statistics and mixed-effects linear regression were used for analysis.

    Results

    The sample (n = 24) had a mean age of 59 ± 12 years, was predominantly female (63%), and represented minority groups (8% White, 52% Black, 33% Hispanic, and 8% Other). Feasibility was supported by 79% retention and 89% completion rates. The recruitment rate (68%) was slightly lower than expected. Acceptability scores were 87.9% for the acupuncture group and 51.7% for the control group. Outcomes were significantly better for the acupuncture versus control groups (API, b = -2.1 (1.1), p = 0.047; functional status, b = 27.6 (7.2), p < 0.001; and HRQoL, b = 38.8 (11.9), p = 0.001).

    Conclusions and implications

    Acupuncture was feasible and acceptable in our diverse sample. We were slightly under the recruitment target of 80%, but participants who started the study had a high likelihood of completing it. Acupuncture shows promise for stable angina, but its effectiveness needs to be confirmed by a larger, adequately powered RCT.

    Trial registration number

    NCT02914834 (ClinicalTrials.gov).
      Cover page: Feasibility and preliminary efficacy of acupuncture for angina in an underserved diverse population
      • Article
      • Peer Reviewed
      UCLA Previously Published Works (2022)

      Aims

      Test for an association between prehospital delay for symptoms suggestive of acute coronary syndrome (ACS), persistent symptoms, and healthcare utilization (HCU) 30-days and 6-months post hospital discharge.

      Background

      Delayed treatment for ACS increases patient morbidity and mortality. Prehospital delay is the largest factor in delayed treatment for ACS.

      Methods

      Secondary analysis of data collected from a multi-center prospective study. Included were 722 patients presenting to the Emergency Department (ED) with symptoms that triggered a cardiac evaluation. Symptoms and HCU were measured using the 13-item ACS Symptom Checklist and the Froelicher's Health Services Utilization Questionnaire-Revised instrument. Logistic regression models were used to examine hypothesized associations.

      Results

      For patients with ACS (n = 325), longer prehospital delay was associated with fewer MD/NP visits (OR, 0.986) at 30 days. Longer prehospital delay was associated with higher odds of calling 911 for any reason (OR, 1.015), and calling 911 for chest related symptoms (OR, 1.016) 6 months following discharge. For non-ACS patients (n = 397), longer prehospital delay was associated with higher odds of experiencing chest pressure (OR, 1.009) and chest discomfort (OR, 1.008) at 30 days. At 6 months, longer prehospital delay was associated with higher odds of upper back pain (OR, 1.013), palpitations (OR 1.014), indigestion (OR, 1.010), and calls to the MD/NP for chest symptoms (OR, 1.014).

      Conclusions

      There were few associations between prehospital delay and HCU for patients evaluated for ACS in the ED. Associations between prolonged delay and persistent symptoms may lead to increased HCU for those without ACS.
        Cover page: There is little association between prehospital delay, persistent symptoms, and post-discharge healthcare utilization in patients evaluated for acute coronary syndrome.
        Top