The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65681

Mary Ann Littleton, PhD, Department of Public Health, East Tennessee State University, Box 70674, Johnson City, TN 37614-1709, 423-439-5247, littleto@etsu.edu, Carol Cornell, PhD, Division of Preventive Medicine, Behavioral Medicine Unit, University of Alabama at Birmingham, 1717 11th Ave. South, Office 641, Birmingham, AL 35205, LeaVonne Pulley, PhD, Health Behavior, University of Alabama at Birmingham, RPHB 227, 1530 3RD AVE S, Birmingham, AL 35294-0022, and Snigdha Mukherjee, PhD, Department of Psychiatry, University of Arkansas for Medical Science, 4301 W. Markham St. #554, Little Rock, AR 72205.

Formative data collected as part of the Uniontown Health Project, a community-based cardiovascular disease (CVD) prevention project for African-American women in rural Alabama conducted by the University of Alabama at Birmingham Center for Health Promotion, discovered the perception that stress and coping are important etiological factors for heart disease. In order to explore a stress-coping-CVD risk model, a perceived chronic sources of stress instrument (PCSSI) and a CVD-related coping instrument (CVD-Coping) were developed that reflected community stressors and CVD-related coping responses. Validation of newly developed measures preceded exploration of the Stress-Coping-CVD Risk Conceptual Model, which was developed from previous psychological, sociological, and public health theories, frameworks, and models. Exploratory and confirmatory factor analysis procedures revealed a two-factor solution with good fit and reliability for PCSSI and CVD-Coping. PCSSI was found to be comprised of internal (household) and external (public) sources of stress. CVD Coping was found to be comprised of health-compromising and health-enhancing coping responses. Exploration of the Stress-Coping-CVD Risk Conceptual Model using structural equation modeling procedures (N=396) found nutrition and physical activity structural models to have acceptable fit and weak to moderate ability to predict CVD risk-reduction behaviors and medical risk factor status. A significant health-risk indirect relationship was observed for internal stress, health-compromising coping, and nutrition behavior. A significant health-protective indirect relationship was observed for external stress, health-enhancing coping, and physical activity behavior. Implications of study findings suggest the need to explore the use of stress and coping-based CVD prevention strategies for intervening with similar populations.

Learning Objectives:

• After the session, particpants will be able to: 1)recognize the need for incorporating community models of health and illness in community-based programs, 2)understand the importance of developing stress and coping measures that specifically address personal and community level stressors and disease-related coping responses, 3)relate the study findings to their community health projects and public health roles.

Keywords: Community-Based Health Promotion, African American

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.