Effect of a school-based interventional package on the cardiovascular risk of adolescents

Abstract

Background: Cardiovascular diseases (CVDs) are the number one cause of death globally. Several risk factors are associated with CVDs evident in childhood through adolescence. The major metabolic risk factors include high blood pressure (BP), increased body mass index (BMI), raised blood glucose, raised blood lipids and increased waist circumference (WC). Physical activity, diet, BP, WC, obesity and cardiovascular fitness are the risk factors that can be measured non invasively among adolescents. The identification of these risk factors in adolescents can enable healthcare providers to initiate interventions to reduce the risk and help adolescents to move forward to healthier adulthood in the future. Objectives: The objectives of the present study were to assess the cardiovascular risk of adolescents and to evaluate the effect of a school based interventional package on the cardiovascular risk for adolescents with high cardiovascular risk. Methods: The study was conducted in two phases. Phase I adopted a descriptive design and Phase II adopted a quasi experimental non equivalent control group before and after design. It was conducted in four schools among 401 adolescents aged 10–14 years and their mothers who have given signed consent. The sociodemographic data sheet and the 24 h recall of the adolescents were completed by the mothers. The adolescents completed a physical activity questionnaire child The Physical activity questionnaire for older children and the tobacco, alcohol and drug questionnaire in their classroom. The height, weight, BP and WC were measured as per standard procedures. The 20 m shuttle run was conducted to assess their cardiovascular fitness and levels and shuttles obtained by the adolescents were recorded and graded. The BMI was calculated. The adolescents (n = 31) with the highest risk scores in the experimental schools underwent a school based interventional package. The control group (n = 30) did not have any intervention. The post tests were conducted on the last day of the 8th and 16th weeks using the cardiovascular risk scale. Results: The mean score for cardiovascular risk was 14.35 with a standard deviation of 3.23. There was a statistically significant difference in the cardiovascular risk scores of the adolescents between the control and experimental group in post test 1 (t = 5.69; P = 0.001) at the 8th week and post test 2 (t = 11.61; P = 0.001) at the 16th week. Hence, it can be concluded that a school lbased interventional package elicited a reduction in cardiovascular risk among adolescents. Conclusion: Nurses, particularly school health nurses, can play a pivotal role in encouraging cardiovascular risk surveillance programmes among adolescents in school and to conduct multi component interventional programmes including education, physical activity and diet.