title: Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease.
abstract: Compared with men, women have poorer lipid control. Although potential causes of this disparity have been explored, it is unknown whether patient-centered factors such as satisfaction and confidence contribute. We evaluated (1) whether satisfaction with lipid control and confidence in ability to improve it vary by gender and (2) whether sociodemographic characteristics modify the association.
  
  
  
  We evaluated baseline survey responses from the Cardiovascular Intervention Improvement Telemedicine Study, including self-rated satisfaction with cholesterol levels and confidence in controlling cholesterol. Participants had poorly controlled hypertension and/or hypercholesterolemia.
  
  
  
  A total of 428 veterans (15% women) participated. Compared with men, women had higher low-density lipoprotein values at 141.2 versus 121.7 mg/dL, respectively (p < 0.05), higher health literacy, and were less likely to have someone to help track their medications (all p < 0.05). In an adjusted model, women were less satisfied with their cholesterol levels than men with estimated mean scores of 4.3 versus 5.6 on a 1-10 Likert scale (p < 0.05). There was no significant difference in confidence by gender. Participants with support for tracking medications reported higher confidence levels than those without, estimated mean 7.8 versus 7.2 (p < 0.05).
  
  
  
  Women veterans at high risk for cardiovascular disease were less satisfied with their lipid control than men; however, confidence in ability to improve lipid levels was similar. Veterans without someone to help to track medications were less confident, and women were less likely to have this type of social support. Lack of social support for medication tracking may be a factor in lingering gender-based disparities in hyperlipidemia.
authors.affiliation: 1 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, North Carolina.|2 Division of General Internal Medicine, Department of Medicine, Duke University Medical Center , Durham, North Carolina.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Goldstein
authors.affiliation: 1 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, North Carolina.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Stechuchak
authors.affiliation: 1 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, North Carolina.|2 Division of General Internal Medicine, Department of Medicine, Duke University Medical Center , Durham, North Carolina.
authors.forename: Leah L
authors.initials: LL
authors.lastname: Zullig
authors.affiliation: 1 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, North Carolina.|2 Division of General Internal Medicine, Department of Medicine, Duke University Medical Center , Durham, North Carolina.
authors.forename: Eugene Z
authors.initials: EZ
authors.lastname: Oddone
authors.affiliation: 1 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, North Carolina.|3 Department of Biostatistics and Bioinformatics, Duke University Medical Center , Durham, North Carolina.
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.affiliation: 1 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, North Carolina.
authors.forename: Felicia A
authors.initials: FA
authors.lastname: McCant
authors.affiliation: 4 VA Connecticut Healthcare System , West Haven, Connecticut.|5 Department of Medicine, Yale University , New Haven, Connecticut.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Bastian
authors.affiliation: 6 Division of Endocrinology, Department of Medicine, Duke University Medical Center , Durham, North Carolina.
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Batch
authors.affiliation: 1 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center , Durham, North Carolina.|2 Division of General Internal Medicine, Department of Medicine, Duke University Medical Center , Durham, North Carolina.|7 School of Nursing, Duke University School of Medicine , Durham, North Carolina.|8 Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine , Durham, North Carolina.
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010549:Personal Satisfaction; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents
keywords: chronic disease; disparities; health behavior; women's health