Race/ethnicity and patient confidence to self-manage cardiovascular disease

Document Type

Journal Article

Publication Date



Medical Care


Volume 46, Issue 9

Inclusive Pages



African Continental Ancestry Group--statistics & numerical data; European Continental Ancestry Group--statistics & numerical data; Heart Failure--ethnology; Hispanic Americans--statistics & numerical data; Myocardial Infarction--ethnology; Self Care--utilization; Minority Health


Minority cardiac patients have lower levels of confidence in their abilities to self-manage cardiovascular disease (CVD) than white patients. Poor health and disadvantaged socioeconomic status drive confidence levels related to CVD self-management. Race/ethnicity itself is a dependent factor.

The Expecting Success program was a Robert Wood Johnson funded initiative aimed at improving cardiac care in hospitals serving high volumes of minority patients. This study used data from an evaluation of Expecting Success to examine associations between race/ethnicity and patient confidence levels related to CVD self-management. Equally significant are analyses that assess statistical interactions between race/ethnicity and other patient characteristics.

Key Findings:

  • Black (30%) and Hispanic (36%) patients were disproportionately represented in the lowest confidence bracket.
  • Black and Hispanic patients were two and three times as likely as white patients to fall into the lowest confidence group.

Factors affecting how patients perceive their capacities for self-management of chronic disease include health, poverty, education level and insurance status. Questions remain about what factors lead to what results and what are dependent as opposed to driving factors.

The results of this study will begin to help clinicians identify patients who are most vulnerable to rehospitalization, increased symptom severity, and disease complications.

Peer Reviewed