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Attribution of Risk for Coronary Heart Disease in a Vulnerable Immigrant Population: A Survey Study

Fernandez, Ritin PhD, RN, MN; Davidson, Patricia M. RN, BA, ITC, MEd, PhD; Miranda, Charmaine B Psychology; Everett, Bronwyn PhD, RN; Salamonson, Yenna PhD, RN

doi: 10.1097/JCN.0b013e318276c027

Background: Coronary heart disease (CHD) is a common and costly condition and is increasing at a higher rate among Asian Indians than among other ethnic groups. An understanding of how Asian Indians perceive their risk is important for health providers to develop culturally appropriate programs to raise awareness of the risk of CHD.

Objective: The aim of this survey was to investigate the attribution of risk factors for CHD among the Asian Indian community in Australia.

Methods: Asian Indian community leaders were recruited to provide their views of how their community perceived the risk of CHD. An online survey collected demographic data and information from the Illness Perception Questionnaire–Revised, which measures 6 domains of illness perception: timeline acute/chronic, consequences, emotional impact, personal control, treatment efficacy, and illness comprehension.

Results: An 84% response rate (n = 49) was achieved from Asian Indian community leaders. Heart disease and cancer were considered to be the illnesses of major concern. Participants indicated that people in their community perceived hereditary factors (90%), hypertension, stress or worry (84%), and aging (86%) as the major cause of their illnesses. Smoking, high blood pressure, and cholesterol were identified as being major risk factors for CHD.

Conclusions: These data suggest that as well as strategies to address risk factors such as diet and exercise, stress management is an important issue to consider in developing community-based programs.

Ritin Fernandez, PhD, RN, MN Professor of Nursing, Midwifery and Indigenous Health, School of Nursing, University of Wollongong, and St George Hospital, Kogarah New South Wales, Australia.

Patricia M. Davidson, RN, BA, ITC, MEd, PhD Professor of Cardiovascular Nursing Research, St Vincent’s Hospital; Director of Centre for Cardiovascular and Chronic Care and Professor of Cardiovascular and Chronic Care, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia.

Charmaine Miranda, B Psychology Research Officer, University of Western Sydney, Penrith South DC, New South Wales, Australia.

Bronwyn Everett, PhD, RN Senior Lecturer, School of Nursing and Midwifery, University of Western Sydney, Penrith South DC, New South Wales, Australia.

Yenna Salamonson, PhD, RN Associate Professor, School of Nursing and Midwifery, College of Health & Science, University of Western Sydney, Penrith South DC, New South Wales, Australia.

The authors have no funding or conflicts of interest to disclose.

Correspondence Ritin Fernandez, PhD, RN, MN, Centre for Research in Nursing and Health, St George Hospital and Community Health Service, James Laws House, Level 1, St George Hospital, Kogarah, NSW, 2217 Australia (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins