Mobile-phone text messaging to promote ideal cardiovascular health in women.

OBJECTIVE: Ideal cardiovascular health (CVH) was developed to promote CVH as a key component of primordial prevention. Mobile short message service (SMS) is useful for improving health behaviours. We aim to test the effectiveness of SMS intervention in women to improve CVH. METHODS: In a single-blinded, randomised, controlled study, 620 women, aged 35-70 years, without cardiovascular disease, were enrolled in SMS intervention versus no SMS. CVH metrics by self-report, and biochemical laboratory, anthropometric and blood pressure measurements were collected during home visits at baseline and 9 months. Women were categorised as having poor (0-2), intermediate (3-4) or ideal (5-7) CVH according to the number of ideal CVH metrics. Participants were randomised 1:1 to SMS intervention versus control. SMS was sent every 5-6 days for 9 months. The primary outcome was the difference in the proportion of women with ideal CVH between SMS and control groups at 9 months. Rates of intermediate CVH, poor CVH and each of the seven ideal CV health metrics at 9 months were key secondary endpoints. RESULTS: At 9 months, there was no significant difference between groups for the primary outcome (16.3% at baseline and 13.3% at 9 months, and 10.1% and 11.1%, in SMS and control groups, respectively, adjusted RR 1.0; 95% CI 0.6 to 1.6). Similarly, there were no significant differences between groups for the key secondary endpoints. SMS had an acceptance rate of 94.9%. CONCLUSIONS: Behavioural SMS intervention did not improve rates of ideal CVH in women, despite being feasible and well received. TRIAL REGISTRATION NUMBER: 6377.

Prevalence and determinants of ideal cardiovascular health in a latin women cohort: a cross-sectional study.

Background: Ideal cardiovascular health (CVH) sought to reduce cardiovascular (CV) morbidity and mortality. In Chile, CV mortality in women is high. The study's main aim was to determine the prevalence of ideal CVH, and the factors and behaviors associated with ideal CVH in women from Santiago de Chile. Methods: Cross-sectional study in women between 35 - 70 years old who were selected through a probabilistic, multistage, and geographically stratified sampling. The study included a survey on demographic and CV risk factors and anthropometric, blood pressure, and biochemical measurements. Three categories were used to characterize low (0-2), intermediate (3-4), and high (5-7) levels of AHA's Ideal CVH index. We assessed the prevalence of ideal CVH by age, education level, and socioeconomic status and determined the independent associations of different variables with ideal CVH. Findings: 620 women, mean age 51± 4 years old, were recruited. Ideal CVH prevalence was 14.3%; none of the women presented an ideal healthy diet, and only 22.6% reached an ideal BMI. The best predictors of ideal CVH were a high education level (OR= 2.85; 1.43 to 5.92; p < 0.01), having less than two alcoholic drinks per day (OR= 4.09; 1.60 to 13.77; p< 0.01), and having a pregnancy history without preeclampsia and/or gestational diabetes (OR=1.94; 1.07 to 3.71; p=0.04). Interpretation: This study demonstrates a low ideal CVH prevalence in Chilean women. Education level was a significant factor associated with ideal CVH. But also, women-specific risk factors, such as a history of preeclampsia/gestational diabetes, and alcohol consumption, were important factors related to CVH. Funding: This study was supported by grants from Fundación SOCHICAR de la Sociedad Chilena de Cardiología y Cirugía Cardiovascular, the American Heart Association and an unrestricted grant by TEVA Pharmaceuticals.

Low Cardiovascular Disease Awareness in Chilean Women: Insights from the ESCI Project.

Background: Although cardiovascular disease (CVD) is the leading cause of mortality in Latin American women, limited data exist on CVD perceptions in this population. This study aimed to assess CVD awareness and knowledge of women from Santiago, Chile. Methods: This was a cross-sectional study conducted in women 35 to 70 years old. A multistage probability sampling (stratified by age and socioeconomic level) was used for participant selection. Participants completed a home survey about knowledge of CVD, risk factors, and perceived risk (based on standardized questions from the American Heart Association awareness survey). Results: 723 women participated in the study (mean age: 51 ± 9 years; 17.6% with high education level). Only 9.3% of the respondents mentioned CVD as women's primary health problem, whereas 22.7% and 16.1%, respectively, listed breast cancer and other cancers. When asked to identify the leading cause of women's death, only 14.4% identified CVD compared to 69.1% who recorded cancer. Older women (≥ 55 years) more likely identified CVD as the main cause of death: (OR 2.9: 95% CI = 1.8-4.5) versus younger women (<55 years). CVD family history was also associated with higher awareness of CVD as the leading cause of death (OR 1.7: 95% IC; p = 1.1-2.6). Instead, women with middle education level were less likely to mention CVD as the main women's killer. Conclusions: Chilean women from Santiago have a low awareness of CVD as the leading cause of death and do not recognize CVD as their prominent health problem. Efforts should focus on increasing awareness and knowledge about CVD especially in young women.

The effects of using answer sheets on reported drug use and data quality in a classroom survey: A cluster-randomized study.

BACKGROUND: We compare self-reported prevalence of drug use and indicators of data quality from two different response modes (with and without an independent answer sheet for recording responses) in a survey conducted in 2015 among secondary school students. METHODS: Stratified cluster-randomized study conducted among students in grades 8-12 from public, private and subsidized schools in Chile (N=2317 students in 122 classes). Measurements included were: percentage reporting substance use (tobacco, alcohol, marijuana, cocaine, ecstasy); number of inconsistent responses; number of item nonresponses; percentage of extreme reports of drug use; percentage reporting using the nonexistent drug, relevón; and completion times. RESULTS: Compared with those who responded directly in the questionnaire booklet, students who used a separate answer sheet took 17.6 more minutes (95% confidence interval [CI]: 14.4-20.8) to complete the survey and had on average 1.5 more inconsistent responses (95%CI: 0.91-2.14). The prevalence and variance of drug use was higher among those who used an answer sheet for all substances except tobacco; the prevalence ratio (PR) of reported substance use for low-prevalence substances during the past year were: cocaine PR=2.5 (95%CI: 1.6-4.1); ecstasy PR=5.0 (95%CI: 2.4-10.5); relevón PR=4.8 (95%CI: 2.5-9.3). CONCLUSIONS: Using an answer sheet for a self-administered paper-and-pencil survey of drug use among students result in lower quality data and higher reports of drug use. International comparison of adolescent drug use from school-based surveys should be done with caution. The relative ranking of a country could be misleading if different mode of recording answers are used.