Cardiovascular Diseases Clinical Trial
To elucidate the interrelationship of level of cardiovascular disease knowledge and subsequent clinical health status by merging population-based cardiovascular disease risk factor survey data with patient-level hospital data. The overall goal was to assess outcomes in the positive/negative association between level of cardiovascular disease knowledge and incidence and relative degree of morbidity among a cohort with and without major cardiovascular disease risk factors.
BACKGROUND:
Evidence shows a growing disparity in the prevalence of modifiable risk factors and
incidence of cardiovascular disease between upper and lower socioeconomic status (SES)
individuals. Trends in knowledge about risk factors and risk reduction strategies parallel
these findings. Research determining the differential association between level of
cardiovascular disease knowledge and subsequent clinical health status had not been
conducted.
DESIGN NARRATIVE:
Analyses were stratified according to SES (via years of formal education), controlling for
age, gender, and ethnicity (Latino/Anglo). Sociodemographic, physiologic, and knowledge
measurements were available on each participant. Morbidity estimates and clinical health
status indicators were available via primary and secondary discharge diagnostic codes from
public-use hospital discharge databases collected on all California hospital admissions for
the entire study period. The Stanford Five City Program data were merged with the hospital
discharge data, matching on survey participant's social security number which was
subsequently converted to a unique personal identifier. Baseline 1989/90 and 1991 through
1995 longitudinal outcomes were assessed.
There were three main aims, all of which had epidemiologic and cardiovascular disease health
policy prevention implications: Aim 1: Characterize the distribution of hospitalized versus
non-hospitalized SES sub-cohorts according to level of C.D. knowledge, physiologic risk
factor prevalence, and clinical morbidity prevalence. Aim 2: Test the hypothesis that
morbidity differences between hospitalized SES sub-cohorts would vary as a function of
baseline level of cardiovascular disease knowledge and risk factor prevalence. Aim 3: Test
the hypothesis that morbidity would rise among hospitalized lower SES sub-cohorts, resulting
in widening health status disparities by the end of the study period. Parametric and
nonparametric analytic methods were used, including analysis of variance and covariance, and
various regression techniques.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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