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Effect of Women's Cardiovascular Health Education on Cardiovascular Disease Prevention Practices among Middle-Aged Women in Nigeria

Abstract

Cardiovascular disease (CVD) is a major public health concern and an important cause of illness and premature death among women worldwide. Middle-aged women may experience increasing cardiovascular risk due to ageing, menopause-related changes, hypertension, obesity, physical inactivity, unhealthy dietary patterns, diabetes, tobacco exposure, psychosocial stress, and family history. Despite the importance of prevention, women may have limited awareness of their cardiovascular risk factors and may not consistently engage in recommended preventive practices. Women's cardiovascular health education provides an opportunity to improve knowledge of cardiovascular risk factors, warning signs, healthy lifestyles, regular health screening, and appropriate healthcare-seeking. Against this background, this study investigates the effect of women's cardiovascular health education on cardiovascular disease prevention practices among middle-aged women in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Health Promotion Model. The Health Belief Model explains how women's perceptions of their susceptibility to cardiovascular disease, perceived severity, perceived benefits of preventive practices, perceived barriers, and cues to action may influence cardiovascular disease prevention behaviours. Social Cognitive Theory emphasizes knowledge, self-efficacy, observational learning, social support, and environmental influences in developing and maintaining healthy cardiovascular behaviours. The Health Promotion Model emphasizes individual experiences, perceived benefits and barriers, interpersonal influences, and behavioural factors that influence participation in health-promoting activities. Collectively, these theoretical perspectives provide a suitable framework for explaining how cardiovascular health education may influence cardiovascular disease prevention practices among middle-aged women in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise middle-aged women attending selected hospitals, primary healthcare centres, women's health clinics, community health programmes, workplaces, and other relevant settings across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, organizations, and eligible women. Women's cardiovascular health education will be assessed using indicators such as exposure to structured cardiovascular health education, frequency and duration of educational sessions, information on hypertension, diabetes, obesity, high cholesterol, physical inactivity, unhealthy diet, tobacco exposure, harmful alcohol use, psychosocial stress, menopause-related cardiovascular risk, cardiovascular warning signs, and the importance of routine health screening. Cardiovascular disease prevention practices will be assessed using indicators such as healthy dietary practices, regular physical activity, weight management, blood pressure monitoring, blood glucose and cholesterol screening where appropriate, avoidance of tobacco, responsible alcohol-related practices, stress management, adequate sleep, medication adherence among women with diagnosed conditions, and timely healthcare-seeking. Data will be collected using structured questionnaires and appropriate cardiovascular health and lifestyle assessment instruments. Descriptive statistics will be used to summarize participants' characteristics, exposure to cardiovascular health education, and patterns of prevention practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of cardiovascular health education on cardiovascular disease prevention practices. Where a quasi-experimental design is adopted, prevention-practice scores before and after structured education may be compared, while relevant demographic, socioeconomic, reproductive, health, lifestyle, and healthcare-access factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that women's cardiovascular health education has a significant positive effect on cardiovascular disease prevention practices among middle-aged women in Nigeria. Women who receive structured and evidence-based cardiovascular health education are expected to demonstrate better preventive practices than women with limited exposure to cardiovascular health information. Education may improve awareness of cardiovascular risk factors and encourage healthier dietary choices, regular physical activity, weight management, routine blood pressure monitoring, appropriate screening for other cardiovascular risk factors, stress management, and timely healthcare-seeking. Education may also help women recognize that cardiovascular disease is not exclusively a male health problem and that cardiovascular risk can increase during and after the menopausal transition. However, financial constraints, limited access to healthy foods and recreational facilities, cultural beliefs, low health literacy, competing family responsibilities, inadequate healthcare access, and limited availability of preventive services may reduce the effectiveness of cardiovascular health education. The study therefore expects accessible, culturally appropriate, practical, and regularly reinforced cardiovascular health education to contribute significantly to improved cardiovascular disease prevention practices among middle-aged women in Nigeria. The study is expected to contribute to the literature on women's cardiovascular health education, cardiovascular disease prevention practices, women's health, non-communicable disease prevention, healthy ageing, lifestyle modification, cardiovascular risk reduction, health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare centres, women's health programmes, healthcare providers, community health workers, development partners, and policymakers regarding strategies for reducing cardiovascular disease risk among women. The study will also provide evidence-based recommendations for integrating cardiovascular health education into routine women's healthcare and primary healthcare services, strengthening community-based cardiovascular prevention programmes, training healthcare workers in women's cardiovascular risk communication, improving access to preventive screening, developing culturally appropriate educational materials, and promoting sustainable cardiovascular disease prevention practices among middle-aged women across Nigeria.

Keywords: Women's cardiovascular health education, cardiovascular disease prevention practices, middle-aged women, cardiovascular health, cardiovascular disease, non-communicable diseases, lifestyle modification, health promotion, women's health, Nigeria, public health.