Dare to be aware: Examining stroke risk perception in African American women aged 35-54 in rural Arkansas

Stroke is a leading cause of chronic disability, second leading cause of dementia, and fifth leading cause of death in the U.S. Healthy People 2030 established a goal to improve cardiovascular health and reduce deaths from heart disease and stroke by raising awareness of stroke signs and symptoms and decreasing risk factor prevalence. African American women are at higher risk for stroke at a younger age compared to white women, with women in the 35-54 age group having a three-fold increase in stroke risk. Stroke susceptibility is compounded in rural African American women due to higher stroke risk factor prevalence and insufficient access to preventive resources. More research is needed to investigate the rural African American female experience with risk perception of stroke in women aged 35-54. The purpose of this quantitative study was to explore the relationship among self-identified stroke risk factors, stroke risk perception, and the likelihood of risk reduction behaviors among African American women aged 35-54 residing in rural Arkansas. All participants (n = 152) in this study completed the Cerebrovascular Attitudes and Beliefs Scale-Revised (CABS-R) self-report survey instrument to assess stroke risk factors and stroke risk perception. The CABS-R data were used to explore whether (a) family history of stroke affects risk perception, (b) there is an association between personal stroke risk factors and risk perception, and (c) whether six-month intention to change risk factors is predictive of perceived threat of stroke. Results of independent samples t-tests indicated that there were no significant differences in perceived stroke susceptibility, perceived benefits of stroke risk factor reduction, and perceived barriers to stroke risk factor reduction between those with and without family histories of stroke. However, notable effect sizes were identified for Perceived Susceptibility to stroke among participants with diabetes (-.47), Perceived Susceptibility to stroke regarding lack of medication adherence (.76), and Perceived Barriers to stroke risk factor reduction regarding lack of medication adherence (-.74). Pearson’s correlation revealed there was no statistically significant relationship between the number of self-identified stroke risk factors and perceived stroke severity (r = .07, p = .421). Further, results of the standard multiple linear regression indicated that the model containing inadequate exercise, overweight, and high blood pressure did not significantly predict perceived stroke severity, F(3, 41) = .07, p = .976, R2 < .01. This study found inconsistencies in the ability to accurately identify personal stroke risk factors and align risk factor prevalence with threat perception among rural African American women aged 35-54. Interventions for decreasing stroke morbidity and mortality from this study should focus on increasing risk factor knowledge, awareness, and accuracy of risk factor identification among rural African American women, particularly those at risk for stroke due to family history, high blood pressure, obesity, and inadequate physical activity.