Community-Based Interventions for Cardiovascular Disease Prevention in Low-and Middle-Income Countries: A Systematic Review

Rawlance Ndejjo; Hamid Yimam Hassen; Rhoda K Wanyenze; David Musoke; Fred Nuwaha; Steven Abrams; Hilde Bastiaens; Geofrey Musinguzi

doi:10.3389/phrs.2021.1604018

Community-Based Interventions for Cardiovascular Disease Prevention in Low-and Middle-Income Countries: A Systematic Review

Public Health Rev. 2021 Jun 2:42:1604018. doi: 10.3389/phrs.2021.1604018. eCollection 2021.

Authors

Rawlance Ndejjo^{1

2}, Hamid Yimam Hassen², Rhoda K Wanyenze¹, David Musoke¹, Fred Nuwaha¹, Steven Abrams^{2

3}, Hilde Bastiaens², Geofrey Musinguzi^{1

2}

Affiliations

¹ Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
² Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
³ Data Science Institute, Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), UHasselt, Belgium.

Abstract

Objectives: To synthesize evidence on the effectiveness of community-based interventions for cardiovascular disease (CVD) prevention in low- and middle-income countries (LMICs) to inform design of effective strategies for CVD prevention. Methods: We searched MEDLINE, EMBASE, CINAHL, Cochrane register of controlled studies and PSYCINFO databases for studies published between January 2000 and June 2019. Other studies were identified from gray literature sources and review of reference lists of included studies. The primary outcomes for the review were those aimed at primary prevention of CVD targeting physical activity, diet, smoking and alcohol consumption. Results: Database searches yielded 15,885 articles and 94 articles were identified through snowball searching. After screening, the articles from LMICs were 32 emanating from 27 studies: 9 cluster randomized trials, eight randomized controlled trials and 10 controlled before and after studies. Community-based interventions successfully improved population knowledge on CVD and risk factors and influenced physical activity and dietary practices. Evidence of interventions on smoking cessation and reduced alcohol consumption was inconsistent. Conclusion: This evidence should inform policy makers in decision-making and prioritizing evidence-based interventions.

Keywords: alcohol; cardiovascular disease; community-based; diet; effectiveness; knowledge; physical activity; smoking.