Cultural Adaptation of a Cardiovascular Health Education Program among Hypertensive Primary Care Patients from Rural Nigeria

Abstract

Culturally adapted behavioral treatments can optimize care. Following standard guidelines we adapted and tested a hypertension education program among primary care patients with hypertension from rural Nigeria. We reviewed literature and collected qualitative information from hypertensive patients to implement the first three of five cultural adaptation stages: Information gathering, Adaptation design, and Preliminary adaptation testing. Information obtained was used to adapt a Cardiovascular Health Education Program (CHEP) from a similar program Culturally Appropriate Hypertension Education (CAHE). CHEP was evaluated among 149 hypertensive patients using pre, − post design, and performance of behavioral goals. Data were analyzed using descriptive statistics and thematic contents. CHEP retained essential features of CAHE and added new culturally relevant information. Local context factors like substitutability of dietary salt and exercisability with cultural activities motivated healthy behavior and enhanced cultural fitness. Culturally permissive unhealthy practices were discouraged; intentional weight gain (big is beautiful), and non-smoking tobacco use (sniffing, licking). Performance of behavioral goals was outstanding; over 60% practiced self-set goals effectively. Standard cultural adaptation of behavioral education program demonstrated potential to limit cardiovascular diseases among hypertensive patients. Guideline-based culturally adapted intervention increased hypertension self-management capabilities among hypertensive primary care patients from rural Nigeria.