Background Globally, cardiovascular disease (CVD) was responsible for 17.5 million deaths, accounting for 46.2% non-communicable disease deaths. In Ghana CVDs has been the leading cause of adult death since 2001. Prevalence of CVD risk factors among adolescents in Ghana has been increasing. Objective of this study was to develop, implement and evaluate the effectiveness of a health education intervention program to reduce CVD risk factors among students. Methods A cluster randomized controlled trial was conducted with a school as cluster over a period of six-months with pre and post intervention evaluations. Participants were public secondary school students (14-19 years) from four schools in Brong Ahafo, Ghana. Students in the intervention group were trained by the researchers whereas those of the control group received no intervention. The intervention included health education and physical activity modules. Follow-up data using same questionnaire were collected within two weeks after the intervention was completed. Intention-to-treat analysis was performed after replacing missing values using multiple imputation method. The generalized linear mixed model (GLMM) was used to assess the effects of the intervention. Results Of the 848 study participants, 836 completed the final assessment at six-month. The GLMM showed the intervention was significant in attaining 0.77(p<0.001), 0.72(p<0.001), 0.47(p<0.001), 0.56(p<0.001), and 0.39(p=0.045) higher physical activity, fruits, vegetables, seafood, and water scores respectively for the intervention group over the control group. The intervention was also significant in reducing -0.15(p<0.001), -0.23(p<0.001), -0.50(p<0.001), -0.32(p<0.001), -0.90(p<0.001),-0.87(p<0.001),-0.38(p<0.001),-0.63(p<0.001),-1.63(p<0.001),-0.61(p<0.001),and -1.53(p=0.005) carbohydrates, fats and oils, fried eggs, fried chicken, carbonated drinks, sugar, sweet snacks, salted fish, weight, BMI, and diastolic BP. The ‘’odds’’ of quitting alcohol use in the intervention group was 1.06 times more than in control group. There was no significant effect of the intervention on reducing systolic BP. Conclusions The intervention had positive effect on increasing physical activity, promoting healthy diet, reducing alcohol consumption, weight, BMI, and diastolic BP among students in the intervention arm of the study but had no effect on systolic BP. Findings from this study is recommended to be adopted in the educational curricula in secondary schools. Keywords: Cardiovascular disease, risk factors, behavioral modification intervention, secondary school students, adolescents
Background Cardiovascular diseases (CVD) are the number one public health challenge of the 21st century. Globally, the disease causes more deaths than any other cause. Unfortunately, many people are not aware of CVDs and its risk factors and because of this the disease burden keeps on rising. Objective of this study was to develop, implement and evaluate the effects of a health education program to improve CVD knowledge, motivation, and behavioral skills among secondary school students in Ghana. Methods A parallel single-blind cluster randomized controlled trial was carried out for a period of six-months with baseline and post intervention evaluations. Participants (n=848) were secondary school students of ages of 14-19 years from four schools (clusters) in Brong Ahafo, Ghana. Students in the intervention group received health education intervention whereas those of the control group received no intervention. The intervention included information on cardiovascular diseases and its risk factors, motivation, and behavioral skills modules. At six months, a follow-up data using same questionnaire were collected after the intervention was completed. The generalized linear mixed model (GLMM) was used to assess the overall effects of the intervention. Results Of the 848 students, 836 completed the follow-up assessment immediately after six-month. The GLMM showed the intervention was significant in improving 6.85(p<0.001), 0.90(p<0.001), 0.94(p<0.001) higher total CVD knowledge, motivation, and behavioral skills scores respectively for the intervention group when compared to the control group. Conclusions The intervention was effective in increasing CVD knowledge, motivation, and behavioral skills of students in the intervention arm of the study. It is recommended that the health education module be implemented into secondary schools education curricula in Ghana to improve CVD knowledge, motivation, and behavioral skills. Equipping students with the IMB will reduce CVD risk factors and prevent the onset of CVDs in future.
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