An Experiential Cardiovascular Health Education Program for African American College Students

By Holland, Cecil; Carthron, Dana L. et al. | ABNF Journal, Spring 2014 | Go to article overview

An Experiential Cardiovascular Health Education Program for African American College Students


Holland, Cecil, Carthron, Dana L., Duren-Winfield, Vanessa, Lawrence, Wanda, ABNF Journal


INTRODUCTION AND BACKGROUND

An estimated 82.6 million adults in the United States (U.S.) suffer from cardiovascular diseases (CVD) including coronary heart disease, heart failure, stroke, and high blood pressure (Roger et al, 2011) . CVD was the underlying cause of 33% of deaths in 2007 and was the leading cause of death in 2010 (Heron, 2013). Over 2,400 people die of CVD each day - one every 37 seconds (Kung, Hoyert, Xu & Murphy, 2008). African-Americans are more likely to develop preventable chronic illness compared to their white counterparts (Office of Minority Health, 2009).

In 2009, cardiovascular diseases was the second leading cause of death in North Carolina (NC) accounting for almost a third of all deaths in (29%) (North Carolina Department of Health and Human Services, 2011). According to the NC Department of Health and Human Services (2011), cardiovascular and circulatory diseases were also the leading cause of hospitalization, accounting for more than 160,000 hospitalizations and over $5.2 in hospital charges.

As of 2007,49.7% of U.S. adults aged >20 years (approximately 107.3 million persons) have at least one of the three risk factors: uncontrolled hypertension, high levels of low-density lipoprotein cholesterol (Centers for Disease Control and Prevention [CDC], 2011). There are significant disparities between African-Americans and Whites for CVD deaths, hospitalizations, and risk factors in NC (Healthy North Carolina 2020, 2011). Risk factors such as elevated cholesterol, high blood pressure, family history of heart disease, overweight/obesity, physical inactivity, diet high in fat and sodium, and tobacco use mimic national trends, with marked inequalities for NC African-Americans.

Thus, awareness and prevention of risk factors for CVD in African-Americans are critical. Heart disease remains one of the leading causes of death among African-Americans (Office of Minority Health, 2009). An important population to reach is young adults, who are at a critical juncture in their lives. According to the National College Healthy Risk Behavior Survey, 35% of college students are overweight or obese and this number is higher in African-Americans (approximately 40%) (Fennel, 1997). There is a greater risk of weight gain among African-Americans during and following college (Ajibade, 2011). Black males college students often participant in health behaviors that increase their risk for heart disease (Ajibade, 2010). The Centers for Disease Control and Prevention Youth Risk Behavior Surveillance System (2008 ENREF 5) reported that, nationwide, 29.3% of students describe themselves as slightly or very overweight. Overall, the prevalence of self-reported overweight is higher among female (34.5%) than male (24.2%) students; and higher among white female (34.0%), black female (30.1%), and Hispanic female (39.3%) than white male (23.6%), black male (19.1%), and Hispanic male (28.3%) students.

It is imperative that African-American young adults understand the importance of cardiovascular risks for their future health; learn how to assess their own family history, health and health behaviors, and lifestyle choices; and develop the selfefficacy to make behavioral changes that improve life-long cardiovascular health. Therefore, this pilot study investigated the efficacy of a culturally specific and developmentally appropriate curriculum aimed at cardiovascular risk awareness and behavioral change to reduce risk in African-American college students.

Conceptual Framework

The Health Belief Model provided the framework for the study. This model suggests that health actions are dependent on one's perceived susceptibility to and seriousness of a a potential health problem, perceived benefits and barriers to taking action, cues to action, including knowledge about others who have been affected, and self-efficacy. Beliefs related to readiness and motivation to adopt healthy behaviors include both cognitive and emotional components (Rosenstock, Strecher, & Becker, 1988). …

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