Preventing Cardiovascular

Disease
Understanding Heart Disease

Cristy Cervantes & Misha Stevenson

Los Angeles Pacific University: PUBH 620
April 29, 2021
Preventing Cardiovascular Disease
Contents

Research Proposal: Preventing Cardiovascular Disease 2

Broad Topic Area 2
Literature Review 2
Background/Gap 2
Theoretical Foundation 3
Themes in the Literature 4
Target Population 5
Problem Statement 5
Research Questions 5
Sample and Location 6
Hypothesis/Variables 6
Methodology & Design 7
Purpose Statement 7
Data Collection Approach 8
Data Analysis Approach 8
Evaluation Plan (if applicable) 9
Discussion of Research Implications and Future Direction 9
References 11
Research Proposal: Preventing Cardiovascular Disease

Broad Topic Area

Cardiovascular disease is the leading cause of death which does not discriminate between age

nor racial/ethnic group. Understanding what cardiovascular disease is, how and why it affects the

community will allow one to find alternative solutions for prevention. However, there are some

risk factors that are not inevitable such as genetics and family history.

Literature Review

Background/Gap

According to the CDC, “one person dies every 36 seconds in the United States from

cardiovascular disease,” (CDC, 2020). Cardiovascular Disease is caused by a build-up of

fatty plaque in arteries that can damage blood vessels and blood flow to the heart. This

disease is sometimes hard to diagnose prior to having a heart attack and symptoms should

be monitored as they present themselves extremely differently between males and

females. This build-up of plaque can be caused by many different factors including

smoking, unhealthy diets, lack of exercise, and stress (Mayo, 2021). Cardiovascular

disease prevention programs or interventions have been seen to reduce mortality rates and

prevent CVD. These prevention programs and interventions can include behavioral

interventions that help encourage healthy eating habits, exercise, and other healthy

lifestyle activities.
Theoretical Foundation

The PRECEDE-PROCEED model serves to guide planning, implementing and an

evaluation to modify unhealthy lifestyles.

PRECEDE stands for … 

 Predisposing

 Reinforcing and

 Enabling Constructs in 

 Educational Diagnosis and

 Evaluation

PROCEED stands for ...

 Policy

 Regulatory and

 Organizational Constructs in 

 Educational and Environmental Development

On the other hand, vulnerable and underserved individuals are “even less likely to

participate in healthy lifestyle behaviors to prevent CVD than the general US population”

(Peterson, 2012). It is crucial to find ways to educate the community, promote a healthy
lifestyle, retrain the body and mind on how to eat healthy to improve quality of life thus

improving the heart condition.

Themes in the Literature

Many studies have included the risk factors for Cardiovascular Disease and almost all

literature includes family history, ethnicity, sex, and age as factors that cannot be

controlled. When discussing cardiovascular disease and preventative methods or

interventions to decrease risk of mortality, lifestyle choices are a huge factor. When

considering interventions that may assist with lowering the risk for CVD or preventing it

all together, treatment for CVD often falls into 3 categories: lifestyle changes,

medications, or surgery/invasive procedures. Lifestyle changes are important because

having a healthy diet, getting adequate exercise, and not smoking can contribute to

overall health as well as limiting the amount of fatty plaque that builds up in arteries,

medication can assist in slowing or stopping buildup of plaque in the arteries, and surgery

is sometimes necessary to remove the plaque build-up and prevent worsening symptoms

(Donovan, 2020). Most of the focus for these programs rely on preventative methods to

decrease the risk of developing CVD rather than intervention to reduce mortality. There

is an emphasis on providing information to families to promote healthy habits and diets.

Both preventative solutions and interventions are necessary as some of the risk factors

can’t be controlled. The CDC says that around forty-seven percent of Americans have at

least one risk factor for heart disease. Some of these risk factors include high blood

pressure, high cholesterol and low levels of high-density lipoprotein, smoking, obesity,
 and physical inactivity (Donovan, 2020). Based on the data, it would be vital to start

preventative programs as early as possible to lower the risk of developing CVD.

Target Population

The target population for this research proposal will focus on low-income families and

minorities. Low income individuals and families often have reduced accessibility to

healthcare and struggle to make ends meet as it would be difficult to purchase healthier

foods as it is expensive. “According to a recent UC Davis study published online in BMC

Cardiovascular Disorders, people with lower socioeconomic status have a 50% increased

greater risk of developing heart disease compared to those who are wealthier or better

educated” (Rattue, 2011).

Problem Statement

Globally, cardiovascular disease leads as the top cause of death. With this said, low

income families tend to have a 50% increased risk of developing cardiovascular disease

than people of higher socioeconomic status. This can be due to the lack of health

education, environmental, cultural, and socioeconomic factors. In this proposal, we will

consider the factors that may increase the risk and frequency of heart disease within low

income families and individuals.

Research Questions

R1: To what extent, if any, are low income individuals and families more vulnerable to

cardiovascular disease?
 R2: How do factors, such as demographics, socioeconomic status, and lifestyle behaviors,

play a role in preventing or developing cardiovascular disease?

Sample and Location

To collect the most accurate data, we must choose participants from various backgrounds.

Male and female middle-aged participants are important to this study. These participants

may have culturally diverse backgrounds as well as different familial health histories and

come from different socioeconomic statuses. These participants can be gathered through

quota sampling by going to different neighborhoods such as Beverly Hills and South Los

Angeles to select enough participants of each socioeconomic status.

Hypothesis/Variables

Variables

Predictor Variable (independent): Cardiovascular disease.

Criterion Variable (dependent): Low-income individuals and families.

Moderator Variable: The presence and frequency of other contributing factors such as

demographics (i.e. age, gender, ethnicity, race…), socioeconomic factors (i.e. income,

education), comorbidities, lifestyle/ behaviors (i.e. physical activity, stress, alcohol/drug

use, smoking), medical family history and accessibility to healthcare.

Hypotheses
 H10: Cardiovascular disease does not significantly predict the vulnerability of low-income

individuals and families.

H1a: Cardiovascular disease does significantly predict the vulnerability of low-income

individuals and families.

H20: The presence and frequency of other contributing factors does not significantly

influence the relationship between cardiovascular disease and low-income

individuals/families.

H2a: The presence and frequency of other contributing factors does significantly influence

the relationship between cardiovascular disease and low-income individuals/families.

Methodology & Design

To address the problem statement and the research questions, a noncontrolled and

qualitative method would be implemented. Additionally, participants will be surveyed

and/or interviewed (i.e. telephone or in-person) to investigate complex social processes,

improve health interventions and cross-examine the quality of health care delivery. The

purpose of this design is to further understand the beliefs, values, and motivations that

trigger health behaviors to discontinue with CVD treatments and preventions which will

ultimately create positive lifestyle changes.

Purpose Statement

Cardiovascular disease affects many people in America, but especially those who are

low-income. The purpose of this research project is to better understand the factors that
 contribute to developing Cardiovascular disease and what can be used as a treatment or

prevention program to decrease the amount of people who may die from or develop

lifelong health complications due to CVD. 

Data Collection Approach

By collecting information through surveys and interviews (in-person and telephone) from

families and individuals within low and high income communities we can determine what

lifestyle factors are playing a role in developing CVD and what can be done to prevent or

treat this disease. It is important to uphold the ethics of public health by ensuring that we

“address principally the fundamental causes of disease and requirements for health,

aiming to prevent adverse health outcomes” as well as “achieve community health in a

way that respects the rights of individuals in the community,” (Principles of Public

Health, n.d.). This is important when collecting data because people don’t have to

disclose their personal lifestyle choices or beliefs to benefit others in the community. We

must respect their decisions and consider this when evaluating the data.

Data Analysis Approach

 A descriptive statistical analysis will include histograms, tables and plots which will

allow data to view outlier data points to be evaluated and analyzed how the population

sample will represent the targeted population.

 The types of software that would be used for the statistical analysis would be executed

using SAS, Excel, and Red Cap to appropriately survey the data collected.
  The data that will be provided from participants will make sure informed consents and all

documents have been electronically signed and acknowledged. Additionally, each

participant will be required to fill out to effectively analyze the following data…

o Demographic data: age, gender, address/ zip code, ethnicity, race, education,

income

o Health data: height, weight, medical history, mental health, stress, and

accessibility to healthcare

o Lifestyle factors: physical activity, drug use (illicit if applicable), alcohol use,

smoking/tobacco use

Evaluation Plan (if applicable)

The PRECEDE-PROCEED model will create a guided health promotion planning

process between cardiovascular disease and the low-income population. This model will

focus on improving the quality of life, promote a healthy lifestyle, educate the

community, and retrain the body and mind rather than the treatment of the disease. “Just

as a medical diagnosis precedes treatment, the model assumes that a far-reaching

diagnosis should precede a public health intervention. PRECEDE-PROCEED builds in

monitoring of the intervention, allowing for adjustment and greater effectiveness”

(Community Tool Box, 2021).

Discussion of Research Implications and Future Direction

Cardiovascular disease is the leading cause in death in the United States. According to

the Centers for Disease Control and Prevention “about 18.2 million adults age 20 and

older have Coronary Heart Disease and about 2 in 10 deaths happen in adults less than 65
years old due to preventative heart disease” (CDC, 2020). The evidence in this proposal

will show that cardiovascular disease is more aggressive towards low-income minority

populations than any other populations. The results will suggest the urgency of health

promotion as genetics, lifestyle and environmental factors greatly contribute to CVD as

well as other health problems. Knowing what kind of barriers (i.e. language, culture,

financial, diet, healthcare accessibility, etc..) will help determine the next steps to health

promotion towards healthier generations.

It is important to effectively disseminate information to the public regarding the data we

intend to collect to facilitate future health policy proposals. We believe that most of the

general public may be aware of Heart disease or more formally Cardiovascular disease,

however, a lot of people may not know what the effects may be on one’s health or how to

treat or prevent it. By analyzing the demographics, we as researchers can promote

information in a way that is easily accessible and understandable by most people

regardless of education, income, cultural background, or resource availability. Because

CVD is one of the leading causes of death, it is important that the findings from our

research are available and easily adaptable into everyday life.

 References

CDC. (2020, September 08). Heart disease facts. Retrieved from

https://www.cdc.gov/heartdisease/facts.htm

CDC. (Oct. 22, 2020). Heart Disease. Centers for Disease Control and Prevention. Retrieved 
from https://www.cdc.gov/heartdisease/index.htm

Community Tool Box. (2021). Section 2: PRECEDE/PROCEED. Retrieved from

https://ctb.ku.edu/en/table-contents/overview/other-models-promoting-community-health-and-
development/preceder-proceder/main

Donovan, R. (2020, February 27). Everything You Need to Know About Heart Disease.
Retrieved from https://www.healthline.com/health/heart-disease

Mayo Clinic. (2021, February 09). Heart disease. Retrieved from

https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118

Peterson J. A. (2012). One theoretical framework for cardiovascular disease prevention in

women. The Journal of cardiovascular nursing, 27(4), 295–302.
https://doi.org/10.1097/JCN.0b013e31822072fc

Principles of the Ethical Practice of Public Health (n.d.). Retrieved April 29, 2021, from
https://www.apha.org/-/media/files/pdf/membergroups/ethics/ethics_brochure.ashx

Rattue, P. (Aug. 28, 2011). Lower Income Individuals Have 50% Higher Risk of Heart Disease.
Retrieved from https://www.medicalnewstoday.com/articles/233456