Exploring Cardiovascular Health Knowledge, Attitude, and Practices Among the Fijian Indian Community in New Zealand
Cardiovascular disease (CVD) places a significant burden on the New Zealand (NZ) health system. The growing size and diversity of the migrant community in NZ highlights the importance of effective and culturally targeted health promotion services, identifying barriers to health and promoting healthier lifestyles. CVD is highly prevalent in the Fijian Indian community in NZ. Unless immediate action is taken, this rapidly growing and slowly ageing population will inevitably face significant adverse health outcomes and increase the social and economic burden of CVD on the NZ health system. Knowledge, attitudes and practices (KAP) surveys are employed to better understand what is known, believed and practised about various health conditions in the context of a study population. A limited number of cardiovascular (CV) health-related KAP questionnaires are available in the literature, and there is limited documentation of their development and validation. The level of KAP towards CV health in high-risk populations, such as the Fijian Indian community living in NZ, has not been explored. Thus, the purpose of this study was to develop a descriptive, cross-sectional CV health-related KAP survey to gain a deeper understanding of the Fijian Indian community and to support CV health and disease prevention initiatives.
The study was divided into two phases. The aim of the first phase was to develop and test a questionnaire to measure the level of KAP towards CV health in the Fijian Indian community in NZ. The questionnaire was developed following a thorough literature review and under the guidance of an advisory team (n = 5). Each advisory member assessed the content validity of each question until an item Content Validity Index (I-CVI) of ≥ 0.78 and scale CVI (S-CVI) of ≥ 0.9 was achieved. The final analysis of the developed questionnaire demonstrated moderate to high content validity with mean I-CVI of 0.94 for appropriateness, mean I-CVI of 0.94 for relevance and mean I-CVI of 0.86 for clarity. The overall average agreement (S-CVI/Ave) for the study questionnaire was 0.91. Experts also provided positive feedback on the overall questionnaire. Prior to this analysis, it was difficult to make predictions about how well the developed questionnaire would be received by the target community, because of the lack of research and understanding about this community in NZ. The aim of the second phase was to test the feasibility of applying the developed questionnaire to test the KAP towards CV health in the Fijian Indian community living in Auckland, NZ. During this phase, 30 participants were asked to complete the questionnaire at two timepoints (with a two-week interval) and provide open feedback on the questionnaire. The purpose of this phase was to assess the test–retest reliability of the questionnaire, test for appropriateness and understanding, and evaluate timing. The key findings of this phase showed that the developed questionnaire was feasible and appropriate to assess the level of KAP towards CV health in this community. The next step for this novel study is to evaluate the construct validity of this questionnaire in a larger sample population.