Risk Perception and its Association with Cardiac Risk and Health Behaviors among Urban Minority Adults: The Bronx Coronary Risk Perception Study

Abstract

Purpose. Examine the relationship among risk perceptions, health behaviors, and a measure for actual risk of coronary heart disease (CHD). Design. Cross-sectional survey. Setting/Subjects. Adults from three outpatient medical clinics with at least one CHD risk factor. Measures. Perceived risk using the new Coronary Risk, Individual Perception (CRIP) scale, an index of CHD risk, and summary scores for self-reported diet and exercise. Analysis. Bivariate associations using Spearman rank and Kruskal-Wallis; multiple regression models for outcomes (health behaviors). Results. The 16-item CRIP scale had acceptable internal consistency (α = 0.76; interitem total correlation = 0.34 ± 0.17). The response rate was 80.3%, and the mean age of 256 respondents was 56.6 (± 9.9) years; 70 % were women, 63% Hispanic, and 27% black. CRIP scores were inversely associated with low fat/high fiber intake (r = −0.17; p = .007) and exercise (r = −0.19; p = .003). Among respondents with three or more CHD risk factors (n = 132), 44 % perceived themselves to be at low risk for CHD. In multivariable models, men with high CRIP scores had higher fat intake than women (p = .02), but men exercised more (p = .04). Conclusions. In this study, gender moderated the relationship between risk perception and health behaviors, and many respondents underestimated their risk of CHD. Behavioral intervention research aimed at reducing cardiometabolic risk in minority populations should resolve differences between perceived and actual risk of CHD to foster lifestyle changes and examine temporal relationships between risk perception and health behaviors.