title: Outcomes of a Clinic-Based Educational Intervention for Cardiovascular Disease Prevention by Race, Ethnicity, and Urban/Rural Status.
abstract: Heart disease is the leading killer of women and remains poorly recognized in high-risk groups. We assessed baseline knowledge gaps and efficacy of a survey-based educational intervention.
  
  
  
  Four hundred seventy-two women in clinical settings completed pre-/post-surveys for knowledge of: heart disease as the leading killer, risk factors (general and personal levels), heart attack/stroke symptoms, and taking appropriate emergency action. They received a clinic-based educational intervention delivered by healthcare professionals in the course of their clinical care. Change score analyses tested pre-/post-differences in knowledge after the educational intervention, comparing proportions by race, ethnicity, and urban/nonurban status.
  
  
  
  Knowledge and awareness was low in all groups, especially for American Indian women (p < 0.05). Awareness was overall highest for heart disease as the leading killer, but it was the lowest for taking appropriate action (13% of Hispanic, 13% of American Indian, 29% of African American, and 18% of nonurban women; p < 0.05). For all women, knowledge of the major risk factors was low (58%) as was knowledge of their personal levels for risk factors (73% awareness for hypertension, 54% for cholesterol, and 50% for diabetes). The intervention was effective (% knowledge gain) in all groups of women, particularly for raising awareness of: (1) heart disease as the leading killer in American Indian (25%), Hispanic (18%), and nonurban (15%) women; (2) taking appropriate action for American Indian (80%), African American (64%), non-Hispanic (55%), and urban (56%) women; (3) heart disease risk factors for Hispanic (56%) and American Indian (47%) women; and (4) heart disease and stroke symptoms in American Indian women (54% and 25%, respectively).
  
  
  
  Significant knowledge gaps persist for heart disease in high-risk women, suggesting that these gaps and groups should be targeted by educational programs. We specify areas of need, and we demonstrate efficacy of a clinic-based educational intervention that can be of utility to busy healthcare professionals.
authors.affiliation: 1 Division of Cardiovascular Medicine, University of California , Davis, Davis, California.
authors.forename: Amparo C
authors.initials: AC
authors.lastname: Villablanca
authors.affiliation: 2 Clinical Affairs Division, University of California , Davis Medical Center, Davis, California.
authors.forename: Christina
authors.initials: C
authors.lastname: Slee
authors.affiliation: 3 Department of Internal Medicine, American College of Lifestyle Medicine, University of California , Davis, Davis, California.
authors.forename: Liana
authors.initials: L
authors.lastname: Lianov
authors.affiliation: 4 Department of Pediatrics, Center for Healthcare Policy and Research, University of California , Davis, Davis, California.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tancredi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005006:Ethnicity / Q000193:education* / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic; D044469:Racial Groups / Q000193:education* / Q000706:statistics & numerical data; D012307:Risk Factors; D012424:Rural Population; D057566:Self Report; D014481:United States; D014505:Urban Population; D055815:Young Adult
keywords: community; ethnicity; preventive cardiology; race; rurality