TY - JOUR
T1 - Motivators and Deterrents to Diet Change in Low Socio-Economic Pakistani Patients With Cardiovascular Disease
AU - Barolia, Rubina
AU - Petrucka, Pamela
AU - Higginbottom, Gina Awoko
AU - Khan, Faris Farooq Saeed
AU - Clark, Alexander M.
N1 - Funding Information:
Consuming a healthy diet is a complex human behavior and is informed by an array of interrelated individual and contextual factors. This study highlights the importance of understanding the range of factors that strengthen or hinder CVD-friendly eating. To date, no substantial research is available that has fully explored the factors, gender dynamics, and issues related to the consumption of a healthy diet for people of low SES. This study informs the need for an intersectoral, multilevel approach to this complex and growing global issue. The authors would like to thank the National Institute of Cardiovascular Diseases, Karachi, Pakistan, the Aga Khan University, Karachi, Pakistan, and the study participants for their valuable contributions to this study. Author Contribution RB drafted the manuscript. GAH, FK, AMC helped to refine the draft and PP extensively revised the manuscript. All the authors have approved the final manuscript. Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research received support through the IRDC (International Development Research Center) doctoral award from International Development Research Center, Ottawa, Canada. Ethics Approval The study was ethically approved through ethical review committees at the University of Alberta, Canada (2336) and the Aga Khan University, Karachi, Pakistan (31824). Informed Consent Informed consent was signed by the participants before interviewing the patients. The consent included details on voluntary participation in the study, potential benefits, and potential harm from participation in the study, as well as the right to withdraw from the study at any time without penalty. Participants’ anonymity and confidentially throughout the research process and during the dissemination and publication of the findings was also ensured. ORCID iD Rubina Barolia https://orcid.org/0000-0002-7498-3308
Funding Information:
Rubina Barolia is an Assistant Professor and Assistant Dean Clinical Practice at the School of Nursing And Midwifery (SONAM), Dr Barolia completed her nusring education followed by a Post-RN BscN degree and Masters in Nursing from AKU – SONAM. She completed her doctoral studies from the University of Alberta, Canada. Barolia has also published her work in national and international journals. She has been awarded doctoral fellowship from the International Development Research Centre, Ottawa, Canada; Betty Ford Medical Award, California, USA; and the Adult Health award from AKU. Pammla Petruca is an Associate Professor in the College of Nursing at the University of Saskatchewan in Saskatoon, Saskatchewan, has been an AWB volunteer at the Aga Khan University’s campuses in East Africa since 2011. Pammla has been working with AKU’s School of Nursing and Midwifery on its campuses in Kenya, Tanzania, and Uganda. Gina Awoko Higginbottom is a distinguished professor and award winning, academic, consultant and researcher. She is a qualified nurse, midwife and health visitor and her clinical career as a nurse spans 22 years. Gina completed her PhD at the University of Sheffield and she is the recipient of a number of prestigious awards, a Canada Research Chair (renewed, a recognition of research excellence by peers), a Nursing Research Scholar of the Smith and Nephew Foundation, a Mary Seacole Leadership Award holder and her PhD was supported by a prestigious National Primary Care Research Fellowship, Gina was the first health visitor to receive this award. Her expertise is focused on ethnicity and health with strong dimension focused on international migration and maternity. Faris Farooq Saeed Khan is a Licensed Dental Practitioner by profession who graduated from the University of Karachi, in 2016. Dr. Khan is a keen researcher who has a certification in clinical research from DOW University of Health Sciences. He is currently working as a Research Associate at the School of Nursing And Midwifery (SONAM) – Aga Khan University (AKU), Karachi. Alexander M. Clark is the Associate Dean (Research) and is internationally known for his research, leadership and mentorship. He is Board chair of the International Institute for Qualitative Methodology (IIQM) and Editor-in-Chief of the International Journal of Qualitative Methods. Dr. Clark’s research focuses on psychosocial, behavioural, and organizational dimensions of Coronary Heart Disease (heart failure / acute coronary syndromes). He draws on complexity and Critical Realist theory. Clark uses qualitative methods, systematic review (qualitative / quantitative / meta-analysis).
Funding Information:
The authors would like to thank the National Institute of Cardiovascular Diseases, Karachi, Pakistan, the Aga Khan University, Karachi, Pakistan, and the study participants for their valuable contributions to this study. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research received support through the IRDC (International Development Research Center) doctoral award from International Development Research Center, Ottawa, Canada.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019
Y1 - 2019
N2 - This study explores factors that affect the people of low socioeconomic status regarding food choices after diagnosis with cardiovascular disease. Qualitative approach was used to identify the important factors associated with dietary changes as a result of their disease. Twenty-four participants were interviewed from two cardiac facilities in Karachi, the largest metropolitan city of Pakistan. Data were analyzed to identify the themes using the interpretative description approach. While most participants understood the need for dietary changes, few were able to follow recommended diets. Their food choices were primarily influenced by financial constraints as well as cultural, familial, and religious values and practices. The challenge for health care providers lies in understanding the economical, sociocultural, and religious factors that influence behavioral changes which, in turn, affect dietary choices. It is apparent that cardiovascular risk and disease outcomes for the people of low socioeconomic status are likely to escalate. Thus, it is necessary to address the sociocultural, religious, and behavioral factors affecting dietary choices. Achieving this imperative requires an intersectorial, multilevel intervention for the prevention of cardiovascular diseases in people of low socioeconomic status.
AB - This study explores factors that affect the people of low socioeconomic status regarding food choices after diagnosis with cardiovascular disease. Qualitative approach was used to identify the important factors associated with dietary changes as a result of their disease. Twenty-four participants were interviewed from two cardiac facilities in Karachi, the largest metropolitan city of Pakistan. Data were analyzed to identify the themes using the interpretative description approach. While most participants understood the need for dietary changes, few were able to follow recommended diets. Their food choices were primarily influenced by financial constraints as well as cultural, familial, and religious values and practices. The challenge for health care providers lies in understanding the economical, sociocultural, and religious factors that influence behavioral changes which, in turn, affect dietary choices. It is apparent that cardiovascular risk and disease outcomes for the people of low socioeconomic status are likely to escalate. Thus, it is necessary to address the sociocultural, religious, and behavioral factors affecting dietary choices. Achieving this imperative requires an intersectorial, multilevel intervention for the prevention of cardiovascular diseases in people of low socioeconomic status.
KW - Pakistan
KW - cardiovascular disease
KW - dietary change
KW - healthier diet
KW - low socioeconomic status
UR - http://www.scopus.com/inward/record.url?scp=85075979201&partnerID=8YFLogxK
U2 - 10.1177/2333393619883605
DO - 10.1177/2333393619883605
M3 - Article
AN - SCOPUS:85075979201
SN - 2333-3936
VL - 6
JO - Global Qualitative Nursing Research
JF - Global Qualitative Nursing Research
ER -