Perceived Risk for Cardiovascular Disease and Diabetes Type 2 among Samoans with Metabolic Syndrome

Abstract

Purpose/Aims: To explore the relationship between perceived risk of cardiovascular disease (CVD) and diabetes and the health-world view of Samoans with two or more components of metabolic syndrome.1. Describe participant's perceptions of risk for CVD and diabetes.2. Compare participants' actual risk of CVD and diabetes based on presence of components of metabolic syndrome to their perceived risk of CVD and diabetes.3. Describe the relationships among participants' health-world views and perceived risk for CVD and diabetes.Rationale/Background: Diabetes and CVD are leading causes of health disparities in the United States, particularly among Pacific Islanders, whose rates for CVD and diabetes are among the highest in the Nation. Metabolic syndrome significantly increases risks for CVD and diabetes and can be prevented using behavioral approaches. An important concept in behavioral models, perceived risk is influenced by both sociocultural and health-world views; yet is understudied in Pacific Islanders with regard to CVD and diabetes.Methods and Sample: Questionnaires and focus groups were used in this mixed methods study involving 43 adult Samoans at moderately high risk of CVD or diabetes. Culture brokers were used to access potential participants using a non-probabilistic sampling scheme. Qualitative and quantitative data were analyzed using descriptive statistics and content analysis respectively, and points of convergence, complementarity, and/or divergence were identified.Results/Significance: Over 80% of participants perceived themselves as high risk for CVD and diabetes. Converging and complementary data revealed predominately accurate perceptions of risk for CVD and diabetes. Underestimations of risk were influenced by current behavior. Overestimations of risk were influenced by behavior, physical health, and family and personal history. Nine codes supported the category health-world view. Five ways of knowing: personal, aesthetic, sociopolitical, empiric, and unknowing, and several values and beliefs i.e. respect, family, religion, harmony/balance, and personal responsibility, together with two cultural codes influenced perceived risk for CVD and diabetes. These important influences on perceived risk for CVD and diabetes in Samoan participants can be used to develop interventions targeting CVD and diabetes, thereby meeting Healthy People 2010, the National Institute of Nursing Research (2006) guidelines, and the National Patient Safety goals (2008) goals.