Knowledge of cardiovascular disease prevention: An analysis from two New England communities

Background. Cardiovascular disease (CVD) mortality has been decreasing in t he United States, possibly due in part to educational programs about CVD pr evention. This study investigates CVD risk reduction knowledge among demogr aphic subgroups in two New England cities and how the level of knowledge ch anged in these subgroups over time. Methods. Six independent cross-sectional surveys including a series of open -ended recall CVD knowledge questions were conducted biennially from 1981 t o 1993 as part of the outcome evaluation for the Pawtucket Heart Health Pro gram. We constructed a raw CVD knowledge score and then created an analysis of variance model with knowledge score as the dependent variable and expla natory variables including demographics, survey, and city. Results. CVD prevention knowledge improved significantly over time in both cities and in every demographic subgroup, increasing rapidly from 1981 to a bout 1988 and then plateauing between 1988 and 1993. Adjusted knowledge sco res were higher for people horn in the United States, women, more educated individuals, and those who spoke English at home. The increase in knowledge over time came mainly from an increase in the identification of physical i nactivity, and blood cholesterol/high fat diet as CVD risk factors, while t here was a decrease in the identification of overweight and blood pressure. Conclusions. In order to assure that reductions in CVD morbidity and mortal ity will be sustained, national educational efforts which stress behavior c hange skills as well as knowledge must continue. These programs should focu s particularly on higher risk subgroups, and risk factors such as weight re duction and blood pressure control should be special priorities. (C) 1999 A merican Health Foundation and Academic Press.