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A Cross-Sectional Pilot Study of Knowledge, Perceived Cardiovascular Disease (CVD) Risk and Intention for Lifestyle Change Among South Asian Adults in Aotearoa, New Zealand. Implications for Culturally Appropriate CVD Prevention Programmes

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Thesis embargoed until 19th November 2026(3.4 MB)

Date

2025

Authors

Joseph Amalanathan, Jacintha

Supervisor

Mowat, Rebecca
Mearns, Gael

Item type

Thesis

Degree name

Master of Philosophy

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Publisher

Auckland University of Technology

Abstract

Background: Cardiovascular disease (CVD) is a leading cause of death globally and in Aotearoa, New Zealand, with SA being at a disproportionately higher risk than other ethnicities. The label “SA” is used to refer to people from India (including those from Fiji), Pakistan, Bangladesh, Sri Lanka, Nepal, and Afghanistan. Despite their high risk, there is a notable lack of nationwide culturally appropriate CVD prevention programmes targeting SA in Aotearoa. The current study aimed to 1) explore the knowledge, risk perception of CVD (heart attack and stroke), and intention to change lifestyle (regular PA and heathy dietary practices) among South Asian adults in Aotearoa, and 2) evaluate the feasibility, appropriateness, and relevance of using the Attitudes and Beliefs about Cardiovascular Disease (ABCD) Risk Questionnaire among this population. Exploring these factors will help plan for culturally appropriate education to be delivered within an Aotearoa context. Method: This was a cross-sectional online survey conducted among 51 community-dwelling SA, aged 18 years or older, living in a large metropolitan city in Aotearoa. Participants' knowledge, perceived risk of CVD, and intention to change lifestyle were measured using the self-administered ABCD Risk Questionnaire. Descriptive statistics and non-parametric tests were used to analyse associations between sociodemographic factors, health characteristics (self-reported CVD risk factors), and CVD-related health beliefs. Results: The study findings revealed a high level of understanding about heart attack and stroke risk and prevention; however, the substantial missing data (45%) in this section, specifically in questions about biomedical risk factors such as cholesterol and diabetes, limit the overall assumption of knowledge for this group. Participants perceived their risk of CVD as low. However, they had a moderate to high intention to change their lifestyle and understanding of the benefits of doing so. Most participants (66%) reported having at least one risk factor for CVD. Surprisingly, there was no statistically significant difference in perceived CVD risk across stratified CVD risk groups (based on self-report), suggesting a potential misalignment between calculated CVD risk and perceived CVD risk. However, the perception of having a higher risk of CVD was observed among participants with high blood pressure (BP) compared to those without a history of high BP, which was statistically significant. A moderate positive correlation was found between the intention to adopt healthy behaviours (PA and healthy dietary practices), indicating that participants who are motivated to improve their PA also tend to adopt healthy dietary practices. Conclusion: The study's findings suggest that knowledge is not directly linked to individuals’ perception of their CVD risk or the intention to change lifestyle behaviour to reduce the risk, potentially indicating knowledge alone may not be sufficient to drive lifestyle behaviours in this population. Culturally appropriate interventions that enhance the benefits of PA and healthy dietary practices, with a focus on benefits related to family and community, could be more effective in enabling the adoption of heart-healthy lifestyle practices. Additionally, based on review by experts, the ABCD Risk Questionnaire appears to be feasible, appropriate and relevant for use among this population.

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http://hdl.handle.net/10292/20143

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Masters Theses