A systematic review of the effectiveness of primary health education or intervention programs in improving rural womenʼs knowledge of heart disease risk factors and changing lifestyle behaviours.

Abstract

Background Cardiovascular disease is the leading cause of death and disability for women in Australia. Women living in rural areas are at greater risk of heart disease, because of limited access and availability of healthcare in rural areas. Lifestyle is a major determinant to the risk of heart disease. Risk factors such as smoking, hypertension, diet, physical activity and alcohol intake can be controlled or modified by lifestyle changes. As heart disease develops over many years, women need to be following healthy lifestyle practices and reduce their chance of a first or recurrent heart attack. AimTo determine the effectiveness of primary health education or intervention programs for cardiac risk reduction in healthy women living in rural areas. Inclusion criteriaTypes of participants. Women aged 16-65 years, living in rural areas, who participated in primary healthcare education programs. Types of interventions. Primary health education or intervention programs aimed at improving rural women's knowledge of their risk of heart disease, for example group work, videos, telephone, workshops, educational material and counselling. Types of outcomes. Primary outcomes included: • Knowledge level of heart disease risk factors • Lifestyle modification, for example dietary improvements such as reduced daily salt intake, increased intake of fruit and vegetables and decreased intake of fat, increased frequency of exercise, decreased levels of smoking, alcohol intake within national guidelines • Health assessment measures, for example blood pressure, body weight, cholesterol levels Types of studies. Any randomised controlled trials, other experimental studies, as well as cohort, case-control and cross-sectional studies were considered for inclusion. Search strategy. A search for published and unpublished studies in the English language was undertaken. Methodological qualityEach study was appraised independently by two reviewers using the standard Joanna Briggs Institute instruments. Data collection and analysisInformation was extracted from studies meeting quality criteria using the standard Joanna Briggs Institute tools. Although similar outcomes are explored in many of the studies, the variable outcome measures precluded the use of meta-analysis. Data are therefore summarised in tables or by using narrative analysis.

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