title: Fatalism moderates the relationship between family history of cardiovascular disease and engagement in health-promoting behaviors among at-risk rural Kentuckians.
abstract: OBJECTIVE
  In rural communities that experience high rates of cardiovascular disease (CVD) morbidity and mortality, family history education may enhance risk awareness and support engagement in healthy behaviors but could also engender fatalism. This study was conducted to assess if the relationship between family history and adherence to healthy lifestyle behaviors is moderated by fatalism.
  
  
  METHODS
  Baseline data were obtained from 1,027 adult participants in the HeartHealth in Rural Kentucky study. Multiple linear regression was used to determine whether fatalism moderated the relationship between high-risk family history of CVD and adherence to healthy lifestyle behaviors, controlling for sociodemographic variables and CVD risk factors. The relationship between family history and healthy behaviors was assessed for subgroups of participants divided according to the upper and lower quartiles of fatalism score.
  
  
  RESULTS
  The relationship between high-risk family history of CVD and adherence to healthy behaviors was moderated by fatalism. Among those with the highest quartile of fatalism scores, high-risk family history predicted greater adherence to healthy behaviors, while among those in the lowest quartile, and among those with the middle 50% of fatalism scores, there was no association between family history and healthy behavior scores.
  
  
  CONCLUSIONS
  Family history education can provide people at increased risk for CVD important information to guide health practices. This may be particularly relevant for those with a high degree of fatalistic thinking. In rural communities with limited health resources, family history education, combined with assessment of fatalism, may support better targeted interventions to enhance engagement in healthy behaviors.
authors.affiliation: College of Nursing, University of Kentucky, Lexington, Kentucky.
authors.forename: Gia
authors.initials: G
authors.lastname: Mudd-Martin
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Rayens
authors.forename: Terry A
authors.initials: TA
authors.lastname: Lennie
authors.forename: Misook L
authors.initials: ML
authors.lastname: Chung
authors.forename: Yevgeniya
authors.initials: Y
authors.lastname: Gokun
authors.forename: Amanda T
authors.initials: AT
authors.lastname: Wiggins
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Biddle
authors.forename: Alison L
authors.initials: AL
authors.lastname: Bailey
authors.forename: M J
authors.initials: MJ
authors.lastname: Novak
authors.forename: Baretta R
authors.initials: BR
authors.lastname: Casey
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D008019:Life Style; D016014:Linear Models; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: cardiovascular disease; family history; fatalism; health behaviors; rural health