230135 Is family history risk for incident coronary heart disease in part because of fatalistic health beliefs' influence on health behavior? An empirical test of the Mickey Mantle effect using a population-based sample

Wednesday, November 10, 2010 : 9:15 AM - 9:30 AM

Maya Rom Korin, PhD , Department of Medicine, Columbia University Medical Center, New York, NY
William Chaplin, PhD , Department of Psychology, St. John's University, Jamaica, NY
Jonathan Shaffer, PhD , Department of Medicine, Columbia University Medical Center, New York, NY
Mark Butler, BA , Department of Psychology, St. John's University, Jamaica, NY
Mary Jane Ojie, MA , Department of Psychology, St. John's University, Jamaica, NY
Karina Davidson, PhD , Department of Medicine, Columbia University Medical Center, New York, NY
Objective: To test the hypothesis that fatalistic health beliefs contribute to the association between family history and CHD incidence in a large population-based sample. Based on the health belief model to secondarily evaluate how fatalistic beliefs may lead to poor health behavior, especially in women. Methods: In 1995 2,688 Nova Scotians without prior heart disease were enrolled in the Nova Scotia Health Study (NSHS95) and followed for 10 years. Participants' age and sex were recorded from the medical registry. Physical activity, engagement in exercise, belief in preventability of heart disease, and family history of early CHD were gathered during a home interview. Incident CHD hospitalizations were determined from the provincial health care registry. Results: A fatalistic health belief contributed significantly to the prediction of CHD incidence with family history in the Cox regression model, (HR =2.149, p <.00001). Physical activity (HR= 1.18, p <.00001) and engagement in exercise (HR= 1.372, CI 1.053-1.789, p <.05) also contributed significantly to the prediction of incident CHD, with fatalistic health belief controlled. Gender was a significant effect modifier. Conclusion: The effect of family history on predicting coronary heart disease is mediated by fatalistic health beliefs. Physical activity and exercise, in turn, mediate fatalistic health beliefs predicting incident CHD. These results provide empirical verification of the “Mickey Mantle effect,” and that family history of CHD should not be viewed as an unmodifiable risk factor.

Learning Areas:
Assessment of individual and community needs for health education
Clinical medicine applied in public health
Epidemiology
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
1. Describe the role that fatalistic health beliefs play in the relationship between a family history of heart disease and subsequent incident heart disease. 2. Assess the role that fatalistic health beliefs have on engagement in preventive health behaviors in people with a family history of heart disease. 3. Discuss the importance of educating those with a family history of heart disease to continue to engage in preventive health behaviors. 4. Explain why fatalistic health beliefs are important to address in those with a family history of heart disease.

Keywords: Health Behavior, Heart Disease

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a public health researcher who focuses on disparities in health behaviors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.