Perception and Counseling for Cardiac Health in Breast Cancer Survivors Using the Health Belief Model: Qualitative Analysis
Abstract BackgroundBreast cancer survivors have increased cardiovascular risk compared to those without cancer history. Cardiovascular disease is the most common cause of death in breast cancer survivors. Cardiovascular risk in breast cancer survivors is impacted by both cance...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-07-01
|
| Series: | JMIR Cancer |
| Online Access: | https://cancer.jmir.org/2025/1/e71062 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849429470768791552 |
|---|---|
| author | Sarah Tucker Marrison Nicholas Shungu Vanessa Diaz |
| author_facet | Sarah Tucker Marrison Nicholas Shungu Vanessa Diaz |
| author_sort | Sarah Tucker Marrison |
| collection | DOAJ |
| description |
Abstract
BackgroundBreast cancer survivors have increased cardiovascular risk compared to those without cancer history. Cardiovascular disease is the most common cause of death in breast cancer survivors. Cardiovascular risk in breast cancer survivors is impacted by both cancer treatment–associated effects and in risk factors for breast cancer and cardiovascular disease overlap. Strategies to improve screening for and management of cardiovascular disease in breast cancer survivors are needed to improve the delivery of survivorship care.
ObjectiveThis study aims to assess current cardiovascular risk counseling practices and perceived cardiovascular risk in breast cancer survivors.
MethodsSemistructured interviews were conducted from May to December 2021 with breast cancer survivors identified as having a primary care clinician within an academic family medicine center in Charleston, South Carolina. The interview guide and content were developed using the Health Belief Model with a focus on cardiovascular risk behaviors, risk perception, and barriers to risk reduction. Analysis of categorical data was conducted by frequency and quantitative variables by mean and SD. Template analysis was performed for qualitative analysis. Outcome measures included self-reported history of cardiovascular disease, risk perception, and risk behaviors.
ResultsThe average age of participants (n=19) was 54 (SD 7) years; 68% (13/19) were White and 32% (6/19) were Black or African American. Of the interviewed women, 90% (17/19) reported a personal history and 90% (17/19) reported a family history of cardiovascular disease. Only 53% (10/19) had previously reported receipt of cardiovascular counseling. Primary care most commonly provided counseling, followed by oncology. Among breast cancer survivors, 32% (6/19) reported being at increased cardiovascular risk, and 47% (9/19) were unsure of their relative cardiovascular risk. Factors affecting perceived cardiovascular risk included family history, cancer treatments, cardiovascular diagnoses, and lifestyle factors. Video (15/19, 79%) and SMS text messaging (13/19, 68%) were the most highly reported mechanisms through which breast cancer survivors requested to receive additional information and counseling on cardiovascular risk and risk reduction. Commonly reported barriers to risk reduction such as physical activity included time for meal planning and exercise, resources to support dietary and exercise changes, physical limitations, and competing responsibilities. Barriers specific to survivorship status included concerns for immune status during the COVID-19 pandemic, physical limitations associated with cancer treatment, and psychosocial aspects of cancer survivorship.
ConclusionsBreast cancer survivors identified that factors associated with their cancer diagnosis and treatment both impacted their cardiovascular risk and introduced additional barriers to risk reduction. Potential strategies to improve counseling and awareness around cardiovascular risk include video and messaging platforms. Further risk reduction strategies should consider the unique challenges of cancer survivorship in delivery and implementation. |
| format | Article |
| id | doaj-art-680a51bc66d44e0e89cb217b7f07e293 |
| institution | Kabale University |
| issn | 2369-1999 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Cancer |
| spelling | doaj-art-680a51bc66d44e0e89cb217b7f07e2932025-08-20T03:28:21ZengJMIR PublicationsJMIR Cancer2369-19992025-07-0111e71062e7106210.2196/71062Perception and Counseling for Cardiac Health in Breast Cancer Survivors Using the Health Belief Model: Qualitative AnalysisSarah Tucker Marrisonhttp://orcid.org/0000-0003-1793-6473Nicholas Shunguhttp://orcid.org/0009-0001-8050-8917Vanessa Diazhttp://orcid.org/0000-0002-7088-859X Abstract BackgroundBreast cancer survivors have increased cardiovascular risk compared to those without cancer history. Cardiovascular disease is the most common cause of death in breast cancer survivors. Cardiovascular risk in breast cancer survivors is impacted by both cancer treatment–associated effects and in risk factors for breast cancer and cardiovascular disease overlap. Strategies to improve screening for and management of cardiovascular disease in breast cancer survivors are needed to improve the delivery of survivorship care. ObjectiveThis study aims to assess current cardiovascular risk counseling practices and perceived cardiovascular risk in breast cancer survivors. MethodsSemistructured interviews were conducted from May to December 2021 with breast cancer survivors identified as having a primary care clinician within an academic family medicine center in Charleston, South Carolina. The interview guide and content were developed using the Health Belief Model with a focus on cardiovascular risk behaviors, risk perception, and barriers to risk reduction. Analysis of categorical data was conducted by frequency and quantitative variables by mean and SD. Template analysis was performed for qualitative analysis. Outcome measures included self-reported history of cardiovascular disease, risk perception, and risk behaviors. ResultsThe average age of participants (n=19) was 54 (SD 7) years; 68% (13/19) were White and 32% (6/19) were Black or African American. Of the interviewed women, 90% (17/19) reported a personal history and 90% (17/19) reported a family history of cardiovascular disease. Only 53% (10/19) had previously reported receipt of cardiovascular counseling. Primary care most commonly provided counseling, followed by oncology. Among breast cancer survivors, 32% (6/19) reported being at increased cardiovascular risk, and 47% (9/19) were unsure of their relative cardiovascular risk. Factors affecting perceived cardiovascular risk included family history, cancer treatments, cardiovascular diagnoses, and lifestyle factors. Video (15/19, 79%) and SMS text messaging (13/19, 68%) were the most highly reported mechanisms through which breast cancer survivors requested to receive additional information and counseling on cardiovascular risk and risk reduction. Commonly reported barriers to risk reduction such as physical activity included time for meal planning and exercise, resources to support dietary and exercise changes, physical limitations, and competing responsibilities. Barriers specific to survivorship status included concerns for immune status during the COVID-19 pandemic, physical limitations associated with cancer treatment, and psychosocial aspects of cancer survivorship. ConclusionsBreast cancer survivors identified that factors associated with their cancer diagnosis and treatment both impacted their cardiovascular risk and introduced additional barriers to risk reduction. Potential strategies to improve counseling and awareness around cardiovascular risk include video and messaging platforms. Further risk reduction strategies should consider the unique challenges of cancer survivorship in delivery and implementation.https://cancer.jmir.org/2025/1/e71062 |
| spellingShingle | Sarah Tucker Marrison Nicholas Shungu Vanessa Diaz Perception and Counseling for Cardiac Health in Breast Cancer Survivors Using the Health Belief Model: Qualitative Analysis JMIR Cancer |
| title | Perception and Counseling for Cardiac Health in Breast Cancer Survivors Using the Health Belief Model: Qualitative Analysis |
| title_full | Perception and Counseling for Cardiac Health in Breast Cancer Survivors Using the Health Belief Model: Qualitative Analysis |
| title_fullStr | Perception and Counseling for Cardiac Health in Breast Cancer Survivors Using the Health Belief Model: Qualitative Analysis |
| title_full_unstemmed | Perception and Counseling for Cardiac Health in Breast Cancer Survivors Using the Health Belief Model: Qualitative Analysis |
| title_short | Perception and Counseling for Cardiac Health in Breast Cancer Survivors Using the Health Belief Model: Qualitative Analysis |
| title_sort | perception and counseling for cardiac health in breast cancer survivors using the health belief model qualitative analysis |
| url | https://cancer.jmir.org/2025/1/e71062 |
| work_keys_str_mv | AT sarahtuckermarrison perceptionandcounselingforcardiachealthinbreastcancersurvivorsusingthehealthbeliefmodelqualitativeanalysis AT nicholasshungu perceptionandcounselingforcardiachealthinbreastcancersurvivorsusingthehealthbeliefmodelqualitativeanalysis AT vanessadiaz perceptionandcounselingforcardiachealthinbreastcancersurvivorsusingthehealthbeliefmodelqualitativeanalysis |