ArticleBMC public health2026
HeartSmart: development and evaluation of a culturally tailored, theory-based cardiovascular health promotion programme for university students in a North-Central Nigerian university - a quasi-experimental pre-post study.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCardiovascular disease (CVD) is the leading cause of mortality in sub-Saharan Africa, with hypertension as the primary modifiable risk factor. Despite a high and largely undetected hypertension burden, no culturally tailored, theory-based cardiovascular health promotion programme has been developed or evaluated for university students in North-Central Nigeria. This study reports the development and evaluation of the HeartSmart Programme, designed to address documented deficits in CVD knowledge, risk perception, and behavioural intentions.
methodsA quasi-experimental single-group pre-test/post-test design was employed. Fifty purposively selected high-risk undergraduate students at the University of Jos (UNIJOS) completed validated ABCD Risk Perception Questionnaire assessments on the programme day. The HeartSmart Programme - a one-day, peer-delivered intervention comprising six evidence-based modules - was developed through systematic needs assessment grounded in Phase 1 baseline findings (N = 1,300) and clinical cardiovascular assessment. Three theoretical frameworks (Health Belief Model, Social Cognitive Theory, Theory of Planned Behaviour) were explicitly operationalised into programme content. Paired-samples t-tests and Cohen's d quantified pre-post changes.
resultsSignificant improvements were observed across all four ABCD domains (all p ≤ 0.013). CVD knowledge demonstrated a large effect (d = 1.42; 73.0% to 93.3%; p < 0.001), with 'good knowledge' increasing from 26.0% to 90.0% of participants. Perceived benefits/exercise intentions showed a medium-large effect (d = 0.73; p < 0.001). Healthy eating intentions showed a small-to-medium effect (d = 0.48; p = 0.001). Perceived risk showed a small but significant effect (d = 0.36; p = 0.013). Programme fidelity was excellent: 98% content coverage, 100% retention, and satisfaction 4.74/5.00.
conclusionsHeartSmart demonstrates that a brief, theory-based, culturally tailored CVD health promotion programme can achieve large knowledge improvements and meaningful attitudinal changes in high-risk university students at a North-Central Nigerian university. Findings are limited to immediate post-programme effects; longitudinal research is needed to assess behavioural and clinical translation. The programme offers a replicable, low-resource model for primordial CVD prevention in sub-Saharan African university settings.
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