Author ORCID Identifier
0009-0003-9363-3834
Date of Award
8-31-2026
Document Type
Open Access Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
First Advisor
Dr. Laura L. Hayman
Second Advisor
Dr. Ling Shi
Third Advisor
Dr. Julie A. Wright
Abstract
Hypertension is a major modifiable risk factor for cardiovascular disease (CVD). Emerging adulthood (ages 18–29) is critical for establishing lifestyle behaviors that shape long-term cardiovascular health. The American Heart Association's Life's Essential 8 (LE8) framework emphasizes key cardiovascular health behaviors, yet evidence on emerging adults' engagement remains limited. Guided by the Health Belief Model, this study examined relationships among hypertension-related cardiovascular knowledge, CVD risk perception, self-efficacy, and engagement in LE8 health behaviors. A cross-sectional online survey was conducted with 506 United States emerging adults. Measures included hypertension-related cardiovascular knowledge, CVD risk perception, self-efficacy, and four LE8 behaviors: diet quality, physical activity, nicotine exposure, and sleep health. Analyses included multivariable logistic and ordinal regression, mediation through generalized structural equation modeling, and moderation analysis, adjusting for sociodemographic and health-related covariates. Hypertension-related cardiovascular knowledge and CVD risk perception showed inconsistent associations with LE8 behaviors. Self-efficacy emerged as the strongest predictor, positively associated with healthy lifestyle category (OR = 1.14, 95% CI: 1.08–1.20, p < 0.001) and meeting more healthy behaviors (OR = 1.11, 95% CI: 1.07–1.15, p < 0.001). Higher income predicted healthier behaviors; disparities were observed by race and BMI. Self-efficacy mediated the relationship between CVD risk perception and physical activity and nicotine avoidance. CVD risk perception did not moderate this relationship. Self-efficacy plays a central role in shaping cardiovascular health behaviors among emerging adults. Knowledge and risk awareness alone appear insufficient for change. Interventions targeting self-efficacy and sociodemographic disparities may improve early adoption of cardiovascular health behaviors.
Recommended Citation
Miezah, Dennis, "Hypertension-Related Cardiovascular Knowledge, Cardiovascular Risk Perception, and Life's Essential 8 Behaviors Among Emerging Adults: A Cross-Sectional Study" (2026). Graduate Doctoral Dissertations. 1213.
https://scholarworks.umb.edu/doctoral_dissertations/1213
Comments
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