Egocentric Health Networks and Cardiovascular Risk Factors in the ECHORN Cohort Study

J Gen Intern Med. 2020 Mar;35(3):784-791. doi: 10.1007/s11606-019-05550-1. Epub 2019 Dec 10.

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Caribbean region.

Objective: This study explored the concept of a health network, relationships focused on health-related matters, and examined associations with CVD risk factors in the Eastern Caribbean.

Design: The Eastern Caribbean Health Outcomes Research Network Cohort Study is an ongoing longitudinal cohort being conducted in the US Virgin Islands, Puerto Rico, Trinidad and Tobago, and Barbados.

Participants: Participants (n = 1989) were English or Spanish-speaking adults 40 years and older, who were residents of the island for at least 10 years, and who intended to live on-island for the next 5 years.

Main measures: Logistic regression was used to examine associations between health network characteristics and CVD risk factors: physical activity, hypertension, and smoking. A baseline survey asked questions about health networks using name generator questions that assessed who participants spoke to about health matters, whose opinions on healthcare mattered, and who they would trust to make healthcare decisions on their behalf.

Key results: Health networks were mainly comprised of family members and friends. Healthcare professionals comprised 7% of networks, mean network size was four, and 74% of health network contacts were perceived to be in "good" to "excellent" health. Persons with larger health networks had greater odds of being physically active compared with those with smaller networks (OR = 1.07, CI = 1.01-1.14).

Conclusions: Health networks may be useful to intervention efforts for CVD risk factor reduction. More studies are needed to examine health networks in Caribbean contexts and explore associations with other CVD risk factors.

Keywords: Caribbean; cardiovascular; hypertension; physical activity; smoking; social network.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cardiovascular Diseases* / epidemiology
  • Caribbean Region
  • Cohort Studies
  • Heart Disease Risk Factors*
  • Humans
  • Risk Factors