Women Veterans' Knowledge of Cardiovascular Disease Risk: Higher Than National Samples and an Opportunity for Innovations

Bean-Mayberry BA, Chanfreau CC, Clair K, Schweizer CA, Dyer KE, Brunner JW, Moreau JL, Huynh AK, Moin T, Finley EP, Hamilton AB. Women Veterans' Knowledge of Cardiovascular Disease Risk: Higher Than National Samples and an Opportunity for Innovations. [Abstract]. Circulation. 2020 Nov 12; 142(Suppl_3):Abstract 17395.

Introduction: One in three American women die of cardiovascular disease (CVD) annually, and evidence shows that while American women's understanding of CVD increased the last 2 decades, knowledge gaps remain. Objective: The objective of this analysis was to assess women Veterans' knowledge in a similar manner to national samples and uncover gaps to target health education or innovations. Methods: Across four VA primary care clinics, we surveyed women Veterans exposed to at least one component of a CV toolkit designed to increase patient engagement and reduce CV risk. Survey included AHA validated measures of leading cause of death, heart attack symptoms, what to do if having a heart attack and risk factors, traumatic life events, depression, provider trust and demographics. Results: Among 140 respondents (average age 61, range 29-88), 65% identified as white, 22% black, 5% Asian, and separately 9% Hispanic. For personal risk, 96% reported at least one CV risk factor, and 60% had 3+ risks. Regarding trauma exposures, 36% reported unwanted or attempted sexual contact and 67% reported experiencing at least one traumatic event (e.g., earthquake/flood, seeing a death/injury, physical or sexual abuse, etc.). More than half (56%) reported depression history. Trust in VA providers was high (mean 9 [SD 1.8], range 1-10). Regarding knowledge, 64% correctly identified heart disease as the leading cause of death, 68% correctly identified all 5 symptoms of a heart attack, (97% knew at least one symptom), and 94% identified correct action to take if someone is experiencing a heart attack (call 911). Conclusions: Nearly all had a CVD risk, over half reported 3+ risks, depression and trauma. Despite multiple conditions and complex histories, women Veterans displayed higher levels of knowledge about CVD causing death and all 5 heart attack symptoms compared to national samples (Mosca 2006; 55% for cause of death; Fang 2019; 50.2% for all symptoms). Responses for calling 911 were similar to national data (Fang 2019; 94.7%).High levels of provider trust and baseline knowledge in women Veterans offer an opportunity to create novel VA interventions that account for women's trauma/mental health needs combined with traditional CVD risks to change the trajectory of CVD outcomes