Forthcoming Issue Vol. 20 No. 1 Preventing Hypertension in sub-Saharan African Youth: A Scoping Review of Interventions and the Potential of Precision Prevention
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Abstract
Introduction: Hypertension significantly contributes to the global burden of cardiovascular disease, especially in low- and middle- income countries, including sub-Saharan Africa. This paper aims to identify existing interventions targeting hypertension prevention among youth aged 13-25 years and evaluate the incorporation of precision prevention strategies. In doing so, this review seeks to guide future efforts in reducing hypertension among young populations in SSA.
Methods and analysis: A scoping review aimed to identify interventions for hypertension risk reduction in SSA and map research in this area. Searches across academic databases and grey literature identified 3301 articles. After removing duplicates, 3089 articles were screened, with data extracted using a custom template on Covidence and analysed descriptively using narrative synthesis.
Results: The review identified six interventions targeting hypertension prevention among youth in SSA. While some interventions reported efficacy in improving adherence to dietary guidelines and physical activity, others showed mixed results, particularly regarding substance use. Interventions varied in design, setting, and duration, with a focus on internal (psychological/knowledge-based) and external (health behaviour) conditions. None of the interventions utilised precision prevention methodologies.
Conclusion: This review identified limited but diverse youth-focused interventions for NCD prevention in SSA, none specifically targeting hypertension or using precision prevention (PP). Despite structural and socio-cultural barriers, tailored PP strategies, youth involvement, and theory-based frameworks show promise for enhancing engagement, sustainability, and impact in hypertension prevention for high-risk youth in SSA.
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References
1. Bai J, Cui J, Shi F, Yu C. Global epidemiological patterns in the burden of main non-communicable diseases, 1990-2019: Relationships with socio-demographic index. Int J Public Health. 2023 Jan 16;68:1605502. doi: 10.3389/ijph.2023.1605502.
2. Kane J, Landes M, Carroll C, Nolen A, Sodhi S. A systematic review of primary care models for non-communicable disease interventions in Sub-Saharan Africa. BMC Family Practice. 2017; 18(46). https://doi.org/10.1186/s12875-017-0613-5
3. Pandey A, Dhimal M, Shrestha N, Sharma D, Maskey J, Dhungana R, Bista B, Aryal K. (2023). Burden of Cardiovascular Diseases in Nepal from 1990 to 2019: The Global Burden of Disease Study, 2019. GHEG. 2023. https://doi.org/10.1155/2023/3700094.
4. Vineis P, Avendano-Pabon M, Barros H, Bartley M, Carmeli C, Carra L, Chadeau-Hyam M, Costa G, Delpierre C, D'Errico A, Fraga S, Giles G, Goldberg M, Kelly-Irving M, Kivimaki M, Lepage B, Lang T, Layte R, MacGuire F, Mackenbach JP, Marmot M, McCrory C, Milne RL, Muennig P, Nusselder W, Petrovic D, Polidoro S, Ricceri F, Robinson O, Stringhini S, Zins M. Special Report: The Biology of Inequalities in Health: The Lifepath Consortium. Front Public Health. 2020 May 12;8:118. doi: 10.3389/fpubh.2020.00118. PMID: 32478023; PMCID: PMC7235337.
5. Mikkelsen B, Williams J, Rakovac I, Wickramasinghe K, Hennis A, Shin HR, Farmer M, Weber M, Berdzuli N, Borges C, Huber M, Breda J. Life course approach to prevention and control of non-communicable diseases. BMJ. 2019 Jan 28;364:l257. doi: 10.1136/bmj.l257. PMID: 30692103; PMCID: PMC6349133.
6. Singh RK, Chang HW, Yan D, Lee KM, Ucmak D, Wong K, Abrouk M, Farahnik B, Nakamura M, Zhu TH, Bhutani T, Liao W. Influence of diet on the gut microbiome and implications for human health. J Transl Med. 2017 Apr 8;15(1):73. doi: 10.1186/s12967-017-1175-y. PMID: 28388917; PMCID: PMC5385025.
7. Silva I, Damasceno A, Fontes F, Araújo N, Prista A, Jessen N, Padrão P, Silva-Matos C, Lunet N. Prevalence of Cardiovascular Risk Factors among Young Adults (18-25 Years) in Mozambique. J Cardiovasc Dev Dis. 2023 Jul 12;10(7):298. doi: 10.3390/jcdd10070298. PMID: 37504554; PMCID: PMC10380744.
8. Prasad RB, Groop L. Precision medicine in type 2 diabetes. J Intern Med. 2019 Jan;285(1):40-48. doi: 10.1111/joim.12859. Epub 2018 Dec 7. PMID: 30403316.
9. Kagura J, Adair LS, Munthall RJ, Pettifor JM, Norris SA. Association between early life and growth and blood pressure trajectories in black South African children. Hypertension. 2016; 68(5), 1123-1131. https://doi.org/10.1161/HYPERTENSIONAHA.116.08046
10. Leopold JA, Loscalzo J. Emerging role of precision medicine in cardiovascular disease. Circ Res. 2018; 122(9), 1302–1315. https://doi.org/10.1161/CIRCRESAHA.117.310782
11. Naithani N, Sinha S, Misra P, Vasudevan B, Sahu, R. Precision medicine: Concept and tools. MJAFI. 2021; 77(3), 249-257. https://doi.org/10.1016/j.mjafi.2021.06.021
12. Bielecka-Dabrowa A, Lewek J, Sakowicz A, Paduszyńska A, Dąbrowa M, Orszulak-Michalak D, Banach M, Cardioplus Investigators. Effects of Implementing Personalized Health Education in Ambulatory Care on Cardiovascular Risk Factors, Compliance and Satisfaction with Treatment. J Pers Med. 2022 Sep 26;12(10):1583. doi: 10.3390/jpm12101583. PMID: 36294722; PMCID: PMC9605047.
13. Adom T, De Villiers A, Puoane T, Kengne AP. School-based interventions targeting nutrition and physical activity, and body weight status of African children: a systematic review. Nutrients. 2019; 12(1), 95. https://doi.org/10.3390/nu12010095
14. Sampson UK, Amuyunzu-Nyamongo M, Mensah GA. Health promotion and cardiovascular disease prevention in sub-Saharan Africa. Prog Cardiovasc Dis. 2013; 56(3), 344–355. https://doi.org/10.1016/j.pcad.2013.10.007
15. Daniels KJ, Hoosen I, Pharaoh H. Health risk behaviour prevention/intervention programmes targeted at youth/adolescents engaging in risky behaviour—a scoping review. J Public Health (Berl.). 2024. https://doi.org/10.1007/s10389-024-02329-5
16. Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169(7), 467-473. https://doi.org/10.7326/M18-0850
17. Peters MD, Godfrey CM, Khalil H, et al. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015; 13(3), 141-6. https://doi.org/10.1097/XEB.0000000000000050
18. Breet E, Matooane M, Tomlinson M, Bantjes J. Systematic review and narrative synthesis of suicide prevention in high-schools and universities: a research agenda for evidence-based practice. BMC Public Health. 2021; 21. https://doi.org/10.1186/s12889-021-11124-w.
19. Herlitz L, Macintyre H, Osborn T, Bonell C. The sustainability of public health interventions in schools: a systematic review. IS. 2020; 15. https://doi.org/10.1186/s13012-019-0961-8.
20. Nickel S, Knesebeck O. Do multiple community-based interventions on health promotion tackle health inequalities?. Int. J. Equity Health. 2020; 19. https://doi.org/10.1186/s12939-020-01271-8.
21. Fedele D, Cushing C, Fritz A, Amaro C, Ortega A. Mobile Health Interventions for Improving Health Outcomes in Youth: A Meta-analysis. JAMA Pediatrics. 2017; 171, 461–469. https://doi.org/10.1001/jamapediatrics.2017.0042.
22. Davis R, Campbell R, Hildon Z, Hobbs L, Michie S. Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychol Rev. 2015;9(3):323-44. doi: 10.1080/17437199.2014.941722. Epub. 2014 Aug 8. PMID: 25104107; PMCID: PMC4566873.
23. Michie S, Jochelson K, Markham WA, Bridle C. Low-income groups and behaviour change interventions: a review of intervention content, effectiveness and theoretical frameworks. J. Epidemiol. Community Health. 2009; 63(8), 610-622. doi:10.1136/jech.2008.078725
24. Nagpaul T, Chen J. Self-determination theory as a Framework for understanding needs of youth at-risk: Perspectives of social service professionals and the youth themselves. Child. Youth Serv. Rev. 2019. https://doi.org/10.1016/J.CHILDYOUTH.2019.02.015.
25. Curran T, Wexler L. School-Based Positive Youth Development: A Systematic Review of the Literature. J. Sch. Health. 2017; 87 1, 71-80 . https://doi.org/10.1111/josh.12467.
26. Barnett E, Concepcion-Zayas M, Zisman-Ilani Y, Bellonci C. Patient-centered psychiatric care for youth in foster care: a systematic and critical review. J. Public Child Welf. 2018; 13, 462 - 489. https://doi.org/10.1080/15548732.2018.1512933.
27. Dzau VJ, Hodgkinson CP. Precision Hypertension. Hypertension; 2023 Dec 19; 81;4;702-708. https://doi.org/10.1161/hypertensionaha.123.21710.
28. Kronish IM, Cheung YK, Shimbo D, Julian J, Gallagher B, Parsons F, Davidson KW. Increasing the precision of hypertension treatment through personalized trials: a pilot study. JGIM;2019 Jun;34:839-845. https://doi.org/10.1007/s11606-019-04831-z.
29. Herman WH, Ye W. Precision prevention of diabetes. Diabetes Care; 2023 Oct 27;46(11):1894-1896. https://doi.org/10.2337/dci23-0052.
30. Weeramanthri TS, Dawkins HJS, Baynam G, Bellgard M, Gudes O, Semmens JB. Editorial: Precision Public Health. Front Public Health; 2018 Apr 30;6:121. doi: 10.3389/fpubh.2018.00121. PMID: 29761096; PMCID: PMC5937027.
31. Ataguba JE, Akazili J, McIntyre D. Socioeconomic-related health inequality in South Africa: evidence from General Household Surveys. Int J Equity Health. 2011; 10, 48. https://doi.org/10.1186/1475-9276-10-48
32. Cicolini G, Simonetti V, Comparcini D, Celiberti I, Nicola M, Capasso L, Flacco M, Bucci M, Mezzetti A, Manzoli L. Efficacy of a nurse-led email reminder program for cardiovascular prevention risk reduction in hypertensive patients: a randomized controlled trial. Int. J. Nurs. Stud. 2014; 51 6, 833-43 . https://doi.org/10.1016/j.ijnurstu.2013.10.010.
33. Soltani S, Saraf‐Bank S, Basirat R, Salehi-abargouei A, Mohammadifard N, Sadeghi M, Khosravi A, Fadhil I, Puska P, Sarrafzadegan N. Community-based cardiovascular disease prevention programmes and cardiovascular risk factors: a systematic review and meta-analysis. Public health. 2021; 200, 59-70 . https://doi.org/10.1016/j.puhe.2021.09.006.
34. Pharaoh H, Frantz J, Smith M. Concept mapping: Stakeholders’ perceptions of what should be included in intervention programmes aimed at reducing engagement in health risk behaviour amongst youth. African J Phys Health Educ Recreat Dance (AJPHEARD) Supplement. 2014; 2:44–58
35. Jemmott JB, Jemmott LS, Ngwane Z, et al. Theory-based behavioral intervention increases self-reported physical activity in South African men: A cluster-randomized controlled trial. Prev Med. 2014; 64, 114-120. https://doi.org/10.1016/j.ypmed.2014.04.012
36. Wentzel-Viljoen E, Steyn K, Lombard C, et al. Evaluation of a mass-media campaign to increase the awareness of the need to reduce discretionary salt use in the South African population. Nutrients. 2017; 9(11), 1238. https://doi.org/10.3390/nu9111238
37. Heeren GA, Jemmott JB, Marange CS, et al. Health-promotion intervention increases self-reported physical activity in sub-Saharan African university students: a randomized controlled pilot study. Behav Med. 2018; 44(4), 297–305. https://doi.org/10.1080/08964289.2017.1350134
38. Srinivas S, Wrench W, Bradshaw K, Dukhi N. Hypertension: preliminary health promotion activity based on service-learning principles at a South African national science festival. J Community Health. 2012; 41, 1-11. https://doi.org/10.1007/s10900-015-0130-1
39. Amoah J, Said S, Rampal L, et al. Effects of a school-based intervention to reduce cardiovascular disease risk factors among secondary school students: A cluster-randomised, controlled trial. PLoS ONE. 2021; 16(11): e0259581. https://doi.org/10.1371/journal.pone.0259581
40. Pienaar AE, Salome Kruger H, Steyn HS, Naudé D. Change over three years in adolescents' physical activity levels and patterns after a physical activity intervention: play study. J Sports Med Phys Fitness. 2012; 52(3), 300–310. https://pubmed.ncbi.nlm.nih.gov/22648469/