Fatalism Moderates the Relationship Between Family History of Cardiovascular Disease and Engagement in Health-Promoting Behaviors Among At-Risk Rural Kentuckians

• Published in: The Journal of rural health 2015-04, Vol.31 (2), p.206-216
• Main Authors: Mudd-Martin, Gia, Rayens, Mary Kay, Lennie, Terry A., Chung, Misook L., Gokun, Yevgeniya, Wiggins, Amanda T., Biddle, Martha J., Bailey, Alison L., Novak, M. J., Casey, Baretta R., Moser, Debra K.
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Aged, 80 and over; Associations; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - psychology; Community health services; Diseases; Education; Family; family history; Family medical history; fatalism; Female; Health Behavior; health behaviors; Health Knowledge, Attitudes, Practice; Health promotion; History; Humans; Kentucky; Kentucky - epidemiology; Life Style; Linear Models; Male; Medical History Taking; Middle Aged; Mortality; Risk; Risk Factors; Rural areas; rural health; Rural Population - statistics & numerical data; Young Adult
• ISSN: 0890-765X; 1748-0361
• DOI: 10.1111/jrh.12094

Purpose In rural communities that experience high rates of cardiovascular disease (CVD) morbidity and mortality, family history education may enhance risk awareness and support engagement in healthy behaviors but could also engender fatalism. This study was conducted to assess if the relationship between family history and adherence to healthy lifestyle behaviors is moderated by fatalism. Methods Baseline data were obtained from 1,027 adult participants in the HeartHealth in Rural Kentucky study. Multiple linear regression was used to determine whether fatalism moderated the relationship between high‐risk family history of CVD and adherence to healthy lifestyle behaviors, controlling for sociodemographic variables and CVD risk factors. The relationship between family history and healthy behaviors was assessed for subgroups of participants divided according to the upper and lower quartiles of fatalism score. Findings The relationship between high‐risk family history of CVD and adherence to healthy behaviors was moderated by fatalism. Among those with the highest quartile of fatalism scores, high‐risk family history predicted greater adherence to healthy behaviors, while among those in the lowest quartile, and among those with the middle 50% of fatalism scores, there was no association between family history and healthy behavior scores. Conclusions Family history education can provide people at increased risk for CVD important information to guide health practices. This may be particularly relevant for those with a high degree of fatalistic thinking. In rural communities with limited health resources, family history education, combined with assessment of fatalism, may support better targeted interventions to enhance engagement in healthy behaviors.