Exploring perceptions of coronary heart disease risk in African American women with type 2 diabetes

African American (AA) women have disproportionately high rates of both coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM). Many women with diabetes do not recognize their risk for CHD and, therefore, fail to engage in prevention behaviors. Leventhal's Theory of Illness Representation (IR) and the Common Sense Model were used in this study to explore the relationships between CHD risk perception and selected factors thought to influence perceptions of risk in AA women with T2DM. An explanatory, mixed methods design was used to examine factors that may affect perceptions of risk for CHD in 48 AA women with T2DM in North Carolina. Initial data collection occurred during home visits using a survey of all participants. A second home visit for semi-structured interviews was conducted with six participants purposefully selected by levels of risk perception. Perception of risk for CHD was not associated with participants' age, socioeconomic status, or duration of diabetes. African American women who knew their highest blood pressure (BP) or their last BP readings perceived their risk for CHD to be higher than those who did not know this information about their BP. A faith-based concept called claiming emerged during the study and influenced beliefs about risk for CHD for many participants. Relationships with their health care providers (HCPs) emerged as an important issue. Based on data from the study, an initial explanatory model of the variables that contribute to CHD risk perception in AA women with T2DM was developed. Perception of risk for CHD is not part of the IR of diabetes for most AA women with T2DM. Claiming or not claiming an illness, as part of participants' faith, may influence risk perception. The relationships between AA women with T2DM and their HCPs are important in the development of the risk perception for CHD and achievement of health outcomes. The results supported previous findings of studies using Illness representations of diabetes