Perception of risk and knowledge of risk factors in women at high risk for stroke.
OBJECTIVE
Women face a higher mortality after stroke and have different risk factors than men. Despite educational campaigns, women continue to underestimate their own risk for stroke. We present a theoretical model to understand risk perception in high-risk women.


METHODS
Eight hundred five women, ages 50 to 70 years, were selected from the University of Connecticut Cardiology Center with at least one risk factor for stroke. A 5-part questionnaire addressed stroke knowledge, risk perception, risk factors, access to health care, and demographics. Two hundred fifteen women responded by mail (28% response rate) and deidentified data were entered in SPSS. Descriptive, bivariate, and multivariate techniques assessed the proposed model.


RESULTS
The cohort was predominantly white (91.5%), higher income (33.1% of the population earned >$75,000), and well-educated (28.6% attended graduate or professional school). Only 2 of the 37 (5.4%) women with atrial fibrillation and 11 of the 71 women with heart disease (15.5%) identified their health condition as a risk factor for stroke. Predictors of risk perception included: other women's risk (B=0.336, P<0.001), worrying about stroke (B=0.734, P<0.001), having hypertension (B=0.686, P=0.037), and having diabetes (B=0.893, P=0.004). Only 63.9% of women with atrial fibrillation (n=23) reported taking warfarin.


CONCLUSIONS
Women were often unable to identify their health condition as a risk factor for stroke. In addition, many women were not undertaking primary prevention behaviors. Risk perception was low, and high-risk women perceived their risk of stroke to be the same as their peers. Educational strategies must advocate for and target high-risk women.
Dearborn
Jennifer L
JL
Department of Neurology, The University of Connecticut Health Center, Farmington, CT 06030-1840, USA.
McCullough
Louise D
LD
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000523:psychology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D010465:Perception; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology*; D011795:Surveys and Questionnaires; D016387:Women's Health