Objective. To explore the perceptions and beliefs regarding cardiovascular risk factors and lifestyle modifications among college students who have been identified as high risk for cardiovascular disease (CVD).
Methods. Using a mixed-methods design, quantitative data was collected to identify participants with high CVD risk. Participants with a Framingham 30-year CVD risk of 10% or higher were invited to participate in the qualitative interviews. Of 148 college students who completed the quantitative portion, 16 were high risk and invited to participate in qualitative interviews. Conventional content analysis was used to analyze interview data.
Results. Ten participants completed the interviews (mean 30-year CVD risk was 19.0% (ranges 10% to 39%). All participants were overweight or obese, 70% consumed alcohol, 60% had elevated blood pressure, 50% had a family history of heart disease, and 20% were current smokers while none had diabetes or hyperlipidemia. Analysis of the in-depth interviews revealed a thematic structure consisting of five primary categories: 1) recognizing risk, 2) lifestyle trajectories, 3) factors influencing lifestyles, 4) ideal healthy lifestyle modifications, and 5) perceived benefits of healthy lifestyles. Recognizing risk, participants had varied responses to the news that they were at risk for CVD, some were not surprised to learn of their cardiovascular risk status while others found this information to be unexpected. Lifestyle trajectory, participants often used their previous lifestyle and behaviors as a context for their current lifestyles. The influencing factors, both facilitators and barriers, are categorized as environmental, relational, financial, work/life/school balance, and internal/intrinsic motivation. Participants described their conceptualizations of an ideal healthy lifestyle modification program and the necessary components for success. The benefits and results of a healthy lifestyle were clearly described as: feeling better and experiencing improved physical tolerance, looking better, reaping the rewards of experiencing results, positive feedback from others, and social acceptance and validation.
Conclusions. Understanding high-risk college students’ beliefs and perceptions regarding CVD risk factors, barriers, facilitators, and strategies for implementing a healthy lifestyle, is the first step to assessing the problem facilitating early intervention which may result in improved long-term cardiovascular health outcomes in the young population.