Exploration of the factors that influence the adoption of healthy lifestyles among Saudis living with Cardiovascular Disease (CVD)

Abstract

Cardiovascular Disease (CVD) remains the leading cause of death and disability-adjusted life worldwide. It has reached overwhelming proportions in many countries around the world, and Saudi Arabia is no exception. Lifestyle interventions are an essential element in the prevention of CVD. However, promoting healthy lifestyle is very challenging because a multitude of factors, including beliefs, social norms, cultural values and environmental factors interact and influence people’s decisions to adopt and maintain healthy lifestyles. The effects of these factors on cardiac patients in the context of Saudi Arabia are largely unknown. To address this gap, this study employed a qualitative design utilising in-depth individual interviews to explore the barriers to and facilitators of the adoption of healthy lifestyles among Saudis living with CVD. Thirteen male and eight female participants from two major hospitals in Jeddah, Saudi Arabia were interviewed. The study used the Framework analysis guided by the work of Ritchie and Spencer to analyse the transcripts. The social ecological model of health promotion provided a theoretical lens through which multiple levels of influential factors were examined from the perspective of CVD patients themselves. Analysis of the data revealed that lifestyle choices are characterised by multiple embedded meanings attached to participants’ lives and reflecting family, religious and cultural values. However, the dominant barrier to the adoption of healthy lifestyle was attributed primarily to constraints imposed by the established cultural and social norms. Other factors include religious beliefs, family values, insufficient healthcare services, physical environment and lack of policy regulations. Thus, while individuals may report having the ability and intention to change, any changes they make are largely shaped by the social and cultural norms in which they are embedded. The findings highlight that educating people on the need for a healthy lifestyle might not be effective unless their individual and contextual issues are considered. This study supports the need for developing comprehensive lifestyle interventions that take account of the complex array of the contextual factors that shape behaviour change to promote the engagement and maintenance of healthy lifestyle among Saudi patients living with CVD. The findings of this study may be used to inform population-based strategies, to integrate these into regional prevention frameworks, and to then translate these into locally delivered healthcare services.