Learning Objective #1: Discuss knowledge of Puerto Rican women about symptoms and risk factors for heart disease

Learning Objective #2: Describe actions taken by Puerto Rican women who experience heart disease symptoms

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Coronary heart disease (CHD) mortality is 20% higher among mainland Puerto Rican (PR) women than Cuban or Mexican American women, and 15% higher than among Caucasian women. While women in general fail to recognize CHD as a serious health risk with symptoms often differing from those experienced by men, little is known about PR women's knowledge, experiences and practices regarding CHD symptoms or risks. This pilot study gathered preliminary data and tested a focus group format to inform a larger investigation regarding knowledge of heart disease symptoms and help-seeking behaviors among PR women. PR women may be unaware of their higher risk or attribute CHD symptoms common among women to more benign ailments for which native remedies are available. Using Krueger and Casey's (2000) framework, five bilingual PR women recruited from a community center in a New England, PR neighborhood participated in an audiotaped focus group. Verbatim text was entered into Ethnograph. Codes and definitions were applied independently and compared across three researchers with reworking to maximize the fit. Emerging themes (watchful waiting, risk recognition, help-seeking) were validated by participants. PR women in this study were unaware of their higher risk for CHD, and did not know the more subtle CHD symptoms commonly experienced by women. The use, particularly among elder PRs, of native remedies to treat symptoms was acknowledged. These findings support the need for a larger investigation that may have implications for health promoting activities to effectively target this high-risk group.