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      Ethnic and gender differences in perceptions of mortality risk in a Canadian urban centre

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          Abstract

          Background:

          Women reportedly do not perceive heart disease (HD) as a major threat to their health; however, men’s perceptions are rarely studied.

          Purpose:

          We explored gender and ethnic differences in risk perception of HD mortality.

          Methods:

          The survey was completed by 976 people 40+ years of age, in metropolitan Vancouver, Canada.

          Results:

          Men, compared with women, were more likely not to know the answer to a question about whether HD is the most common cause of death for women; however, women were more likely not to know the answer to a question about whether HD is the most common cause of death for men. Chinese-Canadian and South Asian-Canadian participants were more likely than participants of other ethnic groups not to know the answer to either question, and the Chinese-Canadian participants were more likely to disagree that HD is the most common cause of death for women.

          Conclusion:

          There is a need to educate the Chinese-Canadian and South Asian-Canadian communities about HD as a first step in promoting health behavior change. Men and women must be educated about the other gender’s risk of HD because all adults play integral roles in making decisions about the prevention of and early intervention for HD.

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          Most cited references14

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          National study of physician awareness and adherence to cardiovascular disease prevention guidelines.

          Few data have evaluated physician adherence to cardiovascular disease (CVD) prevention guidelines according to physician specialty or patient characteristics, particularly gender. An online study of 500 randomly selected physicians (300 primary care physicians, 100 obstetricians/gynecologists, and 100 cardiologists) used a standardized questionnaire to assess awareness of, adoption of, and barriers to national CVD prevention guidelines by specialty. An experimental case study design tested physician accuracy and determinants of CVD risk level assignment and application of guidelines among high-, intermediate-, or low-risk patients. Intermediate-risk women, as assessed by the Framingham risk score, were significantly more likely to be assigned to a lower-risk category by primary care physicians than men with identical risk profiles (P<0.0001), and trends were similar for obstetricians/gynecologists and cardiologists. Assignment of risk level significantly predicted recommendations for lifestyle and preventive pharmacotherapy. After adjustment for risk assignment, the impact of patient gender on preventive care was not significant except for less aspirin (P<0.01) and more weight management recommended (P<0.04) for intermediate-risk women. Physicians did not rate themselves as very effective in their ability to help patients prevent CVD. Fewer than 1 in 5 physicians knew that more women than men die each year from CVD. Perception of risk was the primary factor associated with CVD preventive recommendations. Gender disparities in recommendations for preventive therapy were explained largely by the lower perceived risk despite similar calculated risk for women versus men. Educational interventions for physicians are needed to improve the quality of CVD preventive care and lower morbidity and mortality from CVD for men and women.
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            Tracking women's awareness of heart disease: an American Heart Association national study.

            Cardiovascular disease (CVD) is the leading cause of mortality in men and women in the United States, yet prior research has shown a lack of awareness of risk among women. The purpose of this study was to assess the contemporary awareness, knowledge, and perceptions related to CVD risk among American women and to evaluate trends since 1997, when the American Heart Association initiated a national campaign to improve awareness of CVD among women. A telephone survey of a nationally representative random sample of women was conducted in June and July 2003, with an oversampling of black and Hispanic women; results were compared with those of similar surveys in 2000 and 1997. The present survey included 1024 respondents age > or =25 years; 68% were white, 12% black, 12% Hispanic, and 8% other ethnicities. Awareness, knowledge, and perceptions about heart disease were evaluated by use of a standard interviewer-assisted questionnaire. A shift in awareness of heart disease as the leading killer of women has occurred since 1997. In 2003, 46% of respondents spontaneously identified heart disease as the leading cause of death in women, up from 30% in 1997 (P<0.05) and 34% in 2000 (P<0.05). In contrast, the percentage of women citing cancer as leading cause of death has significantly decreased. Black, Hispanic, and younger women (<45 years old) had lower awareness of heart disease as their leading cause of death than did white and older women. Nearly all women reported comfort in discussing prevention with healthcare providers, but only 38% of women reported that their doctors had ever discussed heart disease with them. Awareness of CVD has increased, although a significant gap between perceived and actual risk of CVD remains. Educational interventions to improve awareness and knowledge are needed, particularly for minority and younger women.
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              Measuring cancer knowledge: comparing prompted and unprompted recall.

              Studies evaluating public knowledge of the warning signs and risk factors associated with cancer have varied in the question format used. Those using a prompted (recognition) format have tended to find higher levels of knowledge than those using an unprompted, recall format. The aim of this study was to quantify the effect of prompting on knowledge of the seven warning signs of cancer, and risk factors for breast and bowel cancer, using data from large representative samples of the UK population. We also tested for demographic differences in the effect of prompting, hypothesizing that prompting would have the greatest impact on groups with least knowledge, specifically men, older and younger people, and those with least education. Analysis of data from four ONS surveys (total n = 5,863) demonstrated significantly higher knowledge of all signs and risk factors in the prompted compared with the unprompted condition. Contrary to our hypothesis, the pattern of interaction of prompting with gender and level of education was inconsistent, and the effect of prompting decreased with increasing age. Implications for future research on cancer knowledge and the most appropriate question format are discussed.
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                Author and article information

                Journal
                Int J Gen Med
                International journal of general medicine
                Dove Medical Press
                1178-7074
                2008
                30 November 2009
                : 1
                : 41-50
                Affiliations
                [1 ]NEXUS
                [2 ]School of Nursing, University of British Columbia, Vancouver, Canada; University of British Columbia, Vancouver, Canada
                Author notes
                Correspondence: Gilat L Grunau, GENESIS and NEXUS, University of British Columbia, 302-6190, Agronomy Road, Vancouver, BC V6T 1Z3, Canada, Tel +1 604 822 5045, Fax +1 604 822 7869, Email gilatgrunau@ 123456gmail.com
                Article
                ijgm-1-41
                2840537
                20428405
                e3ca926f-9292-45a1-841f-07e96b57f11f
                © 2008 Grunau et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Original Research

                Medicine
                risk assessment,heart disease,mortality,gender,ethnic groups
                Medicine
                risk assessment, heart disease, mortality, gender, ethnic groups

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