Chronic Condition: Heart Disease
Cardiovascular disease is the leading cause of death in the United States; it is uniquely impactful in rural populations1. This disparity could be due to cultural, environmental or educational differences, or something else entirely2. For example, cardiovascular disease could be more prevalent (and have increased morbidity and mortality risks) in rural areas due to the lack of available treatment specialists, grocery stores to buy healthy foods, and gyms for people to utilize. Cardiovascular disease is defined as: “all types of diseases that affect the heart or blood vessels, including coronary heart disease … stroke, congenital heart defects, and peripheral artery disease”3.
In this survey, I seek to understand current views about cardiovascular disease in rural populations. By understanding knowledge levels pertaining to cardiovascular disease in rural populations, we can target information campaigns and increase the dissemination of information to positively impact those at risk for and those suffering from cardiovascular disease.
To access the survey, please use this link: https://sarahhyman.typeform.com/to/Kl0TSt. Questions are also listed below:
Which of the following best describes your home neighborhood?
- Urban
- Suburban
- Rural
What is your sex?
- Male
- Female
- Prefer not to say
What is your age? (numerical input response)
Have you ever discussed heart disease with your doctor? This includes risk factors for heart disease, familial history of heart disease, or any concerns you may have about heart disease. This could either have been with your primary care provider or a specialist.
- Yes
- No
Have you or a family member ever been diagnosed with heart disease?
- Yes
- No
- Unsure/Can’t Remember
How would you rate your knowledge of heart disease? This would include information about diet, lifestyle, medications, risk factors, treatments, etc. (scale of 1-10 response)
Do you think heart disease is a concern in your community?
- Yes
- No
- Unsure
What do you think the largest contributors are for heart disease in your community? (choose all that apply)
- Access to fresh and healthy food
- Infrequent access to preventative medical care
- Lack of knowledge about heart disease and its associated risk factors
- No areas to exercise (e.g., sidewalks, gyms, etc.)
- Lack of community-based prevention programs
- Other
*Skip logic*: If you answered “other”, please explain: (short answer)
What is your biggest concern about heart disease? (short answer)
*Integrated logic from previous question*: What makes ___ concerning for you? (long answer)
How would you prefer to receive educational information on heart disease? (choose all that apply)
- From my doctor during regular appointments
- Email/Online/Computer-based communication
- Mailed literature
- Phone calls
- Hospital-based education events (such as open houses)
When developing the survey, I tried to keep it short and to ensure all questions were worthwhile. This was to avoid survey fatigue as many respondents will likely be older and may not be entirely computer literate. When developing surveys, you can use a wide assortment of question techniques such as scales, multiple choice, short answer, and more. Because I am utilizing a web-based survey, I also used skip-logic and integrated questions to better form my survey. You could not use these methods in a paper survey.
To validate the survey, we first would need to pilot test it to ensure the questions being asked are appropriate and respondents are engaging effectively. We would then want to check our internal validity and consistency before revising the survey. Our survey would need to be validated for face, content, criterion related and construct validity4. To do this, we would use the technique of substantive validity analysis5. It is possible the survey could go through several iterations before being utilized in the public. It is incredibly important to ensure that our survey has internal validity to make sure we can draw causal conclusions and we can trust the results from our survey. After the survey is launched, it is important to ensure a representative respondent base so that we can generalize our findings and have good external validity.
References:
- Taylor, H. A., Hughes, G. D., & Garrison, R. J. (2002). Cardiovascular disease among women residing in rural America: epidemiology, explanations, and challenges. American journal of public health, 92(4), 548-551.
- Hartley, D. (2004). Rural health disparities, population health, and rural culture. American Journal of Public Health, 94(10), 1675-1678.
- National Heart Lung and Blood Institute (NIH). (n.d.). Know the Differences: Cardiovascular Disease, Heart Disease, Coronary Heart Disease (p. 1). Retrieved from https://www.nhlbi.nih.gov/sites/default/files/media/docs/Fact_Sheet_Know_Diff_Design.508_pdf.pdf
- Burton, L. J., & Mazerolle, S. M. (2011). Survey instrument validity part I: Principles of survey instrument development and validation in athletic training education research. Athletic Training Education Journal, 6(1), 27-35.
- Hinkin, T. R. (1998). A brief tutorial on the development of measures for use in survey questionnaires. Organizational research methods, 1(1), 104-121.