Oral Presentation Asia Pacific Stroke Conference 2024

Cardiovascular disease and stroke prevention educational-behavioural programs for culturally and linguistically diverse communities: A systematic review and meta-analysis (107391)

Sabine Allida 1 2 , Adriana Angelucci 3 , Scott William 1 , Faisal Alanazi 4 , Seana Gall 5 , Caleb Ferguson 1
  1. Centre for Chronic & Complex Care Research, Western Sydney Local Health District and University of Wollongong, Blacktown, NSW, Australia
  2. The George Institute for Global Health, Sydney, NSW, Australia
  3. Tasmanian Centre for Mental Health Service Innovation, University of Tasmania, Hobart, Tasmania, Australia
  4. School of Nursing, University of Wollongong, Wollongong, NSW, Australia
  5. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia

Background/Aims: Educational-behavioural programs may reduce risk factors and change behaviours in culturally and linguistically diverse (CALD) communities. To investigate the effect of cardiovascular disease (CVD) and stroke prevention educational-behavioural programs for adults from CALD communities on risk factors, disease knowledge and self-reported lifestyle modifications.

Methods: Four electronic databases and trial registries were searched from inception to September 2023. Mean difference (MD) was calculated using a random-effects model, and heterogeneity was assessed using the I2 statistic. The Cochrane Risk of Bias tool and Joana Briggs Institute Critical Appraisal Tool for Quasi-Experimental studies were used to assess the quality of the included studies.

Results:  Ten studies from USA and UK (3 RCTs, 1 cluster RCT, and six quasi-experimental studies) with n=2011 (Mean age 57 years, 53% women) were included. The programs were multi-component, culturally adapted (1 co-designed), and delivered by bilingual community health workers face-to-face, individually or in groups. The program had no effect on SBP mmHg (MD 1.17, 95% CI -1.39 to 3.73, 2 trials, 273 participants) and hbA1c % (MD -0.29, 95% CI -0.89 to 0.32, I2=54%, 2 trials, 273 participants). Five of six studies on disease knowledge reported improvements in CVD or stroke knowledge scores. Three of four lifestyle studies found increased physical activity and fruit and vegetable consumption.    

Conclusion: Educational-behavioural programs for CALD communities improved disease knowledge and lifestyle changes but not risk factors. There is a need to explore other approaches to delivering culturally appropriate CVD and stroke prevention programs to enhance knowledge retention and self-management.