Reducing Cardiovascular disease risks among retired older adults in Osun state Nigeria: an intervention study

Abstract

Purpose: This study aimed to develop, refine, and test an educational intervention programme to improve cardiovascular disease risk reduction among retired older adults in Osun state, Nigeria. Method: The study utilised an exploratory sequential multimethod approach through convergent triangulation of quantitative and qualitative research methods to develop the intervention program. The research setting included three local governments in Osun State, Nigeria. The study was conducted in three phases: In phase one, systematic review was conducted on existing educational interventions for preventing CVD among older adults in Africa. Followed by a qualitative study to explore the barriers and facilitators of educational intervention programmes. Findings from phase one were triangulated in phase two to develop the intervention programme and verified by a Delphi survey. Finally, the developed programme was pilot-tested among 40 participants as a one-group quasi-experimental study. A baseline biophysical profile and questionnaire were obtained at the programme's inception, and the same was repeated six weeks after the programme. Results: The outcome of the systematic review revealed the need for more comprehensive intervention programmes to reduce CVD risk for older adults. Multi-factorial themes identified from the qualitative study further reinforced this need. Results of the Delphi study yielded a content validation index of 0.99, which suggests that the developed programme's content was relevant, comprehensive, and of good quality. The results of the intervention programme were analysed using descriptive and inferential statistics utilising the STATA version 15 statistical package. The primary outcome measured was the level of knowledge of participants on the risk factors of CVD and the assessment of their pre- and post-intervention biophysical profiles. The secondary outcome was the participants' attitude to changes needed to reduce CVD risk. The participants' mean scores improved in their knowledge base of CVD risk from 5.5±1.8 to 6.6±2.0 with a P-value of P=< 0.014. Perception and intention to change also increased from 20.9±4.9 to 21.3±7.4 with a mean difference of 0.3±8.0. viii Conclusion: The developed intervention programme was assessed as effective in creating the needed awareness and behavioural changes to reduce CVD risk among older adults.