Gender-Specific Clustering of Lifestyle Behaviors and Its Impacts on Cardiovascular Health.

BACKGROUND: Unhealthy lifestyle behaviors associated with cardiovascular risk manifest a clustering pattern. OBJECTIVE: Our aim was to identify behavioral clusters by using 5 unhealthy lifestyle behaviors among the Korean population and examine the impacts of identified behavioral clusters on cardiovascular health (CVH). METHODS: A cross-sectional study was conducted using data from the sixth Korea National Health and Nutrition Examination Survey. The participants were 7898, aged 19 to 64 years. The cluster analysis was performed using the behaviors of current smoking, binge drinking, physical inactivity, insufficient fruit intake, and sugar-sweetened beverage drinking. Cardiovascular health was defined as a composite modified z score calculated using biophysical factors. RESULTS: Men manifested 4 clusters (ie, risky binge drinkers, dominant smokers, dominant sugar-sweetened beverage drinkers, and nonsubstance/low-fruit eaters) characterized predominantly by substance use; women had 4 clusters (ie, substance users, physically inactive/low-fruit eaters, physically inactive/fruit eaters, and active adherers) characterized predominantly by physical inactivity. Among men, the clusters of dominant smokers and risky binge drinkers had significantly lower CVH scores than those with poor eating behaviors. Among women, the clusters of substance users and physically inactive/low-fruit eaters had significantly lower CVH scores than the active adherers. All the clusters in men had lower CVH scores than the worst cluster in women. CONCLUSIONS: There was a gender difference in the clustering pattern. The clusters with smoking and binge drinking in men and women were associated with negative impacts on CVH. Healthcare professionals should pay attention to the clustering pattern to design an efficient lifestyle intervention for cardiovascular disease prevention.

Development and psychometric testing of the Heart-Healthy Information Questionnaire.

AIMS: This study aimed to develop a reliable and valid scale, i.e. the Heart-Healthy Information Questionnaire (HHIQ). METHODS AND RESULTS: The HHIQ was developed in three phases: (i) creating the item pool, (ii) conducting a preliminary evaluating the items, and (iii) refining the scale and evaluating psychometric properties. An initial item pool of 77 items with a 3-point True/False format with a 'Don't know' option was extracted from the literature review and 54 items reached content validity. The psychometric properties of HHIQ were tested with 1315 individuals without cardiovascular disease. By using the exclusion criteria of the difficulty index (>0.95), discrimination index (<10.0), and item-total correlation (tetrachoric coefficient <0.2), 50 items were finally selected. The construct validity was determined by using the known-groups validation: Individuals (n = 107) who were educated with heart-healthy education sessions showed significantly higher scores of the HHIQ than those (n = 107) who were not educated (P = 0.015). The Kuder-Richardson formula 20 coefficient indicated good internal consistency (0.85), and the test-retest reliability coefficient with a 15-day interval also indicated good stability (0.78). A total score of the HHIQ was significantly correlated with a total score of the Evaluation Tool for Metabolic Syndrome Modification Lifestyles (ρ = 0.23, P < 0.001). CONCLUSION: The HHIQ showed good psychometric properties of validity and reliability and may be useful to evaluate the knowledge levels of heart-healthy information in the areas of cardiovascular disease prevention.

Intention to quit electronic cigarette smoking among university students who are e-cigarette users.

OBJECTIVE: To identify factors that are significantly associated with the intention to quit electronic cigarette smoking (ECS) at multiple, ecological levels among university students. PARTICIPANTS: 365 students who were e-cigarette users from Seoul metropolitan areas, South Korea. METHODS: A cross-sectional study through an online survey. RESULTS: Of participants, 62.7% had the intention to quit ECS-17.2% within one month, 14.0% within six months, and 31.5% when the time is right. Factors significantly associated with the intention to quit ECS were identified: "device type," "a shorter duration of ECS," and "having started ECS for quitting traditional cigarette smoking" at the intrapersonal-level; "negative attitudes of either peers or family members toward ECS" at the interpersonal-level; and "exposure to community smoking cessation educations" at the community-level. CONCLUSIONS: Approximately one-thirds of university e-cigarette users had no intention to quit ECS. The factors identified should be integrated into university level, behavioral smoking cessation strategies.

Associations of COVID-19 Knowledge and Risk Perception with the Full Adoption of Preventive Behaviors in Seoul.

This study explores the levels of COVID-19 knowledge, risk perception, and preventive behavior practice in Seoul, to determine whether knowledge and risk perception are significantly associated with the full adoption of preventive behaviors, for the delivery of a customized public campaign to Seoul's citizens. A total of 3000 Seoul residents participated in this study through an online questionnaire survey. They had a mean score of 84.6 for COVID-19 knowledge (range: 0-100 points) and 4.2 (range: 1-7 points) for risk perception. Of the participants, 33.4% practiced full adoption of all three preventive behaviors: hand hygiene, wearing a face mask, and social distancing; wearing a face mask was practiced the most (81.0%). Women significantly adopted these three preventive behaviors more often compared with men. Both COVID-19 knowledge and risk perception were found to be significantly associated with the full adoption of preventive behaviors; however, this association differed by the type of preventive behavior. This indicates that city-level information on the levels of COVID-19 knowledge, risk perception, and preventive behaviors should be clearly and periodically communicated among public officers and healthcare professionals to continually raise the public's awareness of the full adoption of non-pharmaceutical preventive behaviors.

Job Stress and Cardiometabolic Lifestyle Modification Behaviors Among Workers in High-risk and Low-risk Workplaces.

OBJECTIVE: There is scarce evidence revealing an association between job stress and cardiometabolic lifestyle modification behaviors among workers. METHODS: A cross-sectional, correlation study was conducted among workers in high-risk and low-risk workplaces by work characteristics. RESULTS: Workers in high-risk workplaces had significantly higher job stress levels than low-risk workplaces. Higher job stress was significantly associated with lower cardiometabolic lifestyle modification behaviors (ß = -0.14, P = .001). This significant association was evident only for high-risk workplaces in total job stress (ß = -0.16, P = .001), including job demand (ß = -0.16, P = .005) and job insecurity (ß = -0.11, P = .026). CONCLUSIONS: Strategies for alleviating job stress should be prioritized to high-risk workplaces, and these efforts may concomitantly contribute to cardiometabolic risk reduction.