Level of utilization of cardiovascular disease risk factor screening and its associated factors among males in Kokuvil Public Health Inspector (PHI) area in Batticaloa District

Abstract

Screening has been recommended as the most effective secondary prevention strategy to tackle the growing public health issue of Cardio Vascular Diseases (CVD). Literature showed that utilization of screening by healthy public is low and males have the least utilization of screening compared to the females. CVDs are high among males thus, it is important to identify factors that lead to low utilization. However, there is a dearth of literature on factors that determine the utilization of CVD risk factor screening by males in both global and local contexts. This study aimed to determine the level of utilization of CVD risk factor screening and its associated factors among males in the Kokkuvil Public Health Inspector (PHI) area in Batticaloa district. A mixed method study was conducted with a qualitative component based on the grounded theory and a quantitative study based on the community-based cross-sectional study design. In-depth interviews among health-care providers and focus group discussions among males in the general public were used to gather data for the qualitative component. Quantitative data was gathered using an interviewer-administered questionnaire. Thematic analysis was used to analyze qualitative data. Quantitative data was analyzed using descriptive and inferential statistics using the Statistical Package for Social Sciences version 23. Bivariate and logistic regression analysis were conducted to assess the associated factors with utilization of screening. The qualitative component of the study found 2 main themes that motivate males to undergo CVD risk factor screening: internal and external motivation and reactive and proactive engagement pathways. It was evident that males are not utilizing screening due to 3 main themes: practical & systemic obstacles, cognitive & motional resistance, and socio-economic influences & community engagement gaps. According to the quantitative component, the overall level of utilization of CVD risk factor screening during lifetime was 52.2% (n=168), and the level of utilization of CVD risk factor screening during last one year was 37.6% (n=121) among males. Bivariate analysis revealed that socioeconomic and demographic factors (age group, employment type, monthly income group and education level of the respondent), personal factors (knowledge about CVDs, its risk factors, family history of CVDs and lifestyle practices namely involve in vigorous physical activities, tobacco consumption, consumption of fast food, and vegetable intake are statistically significantly associated with utilizing screening. Logistic regression analysis found that age group, employment type, knowledge about CVD, tobacco consumption, and vegetable intake have a significant effect on the odds of improving or decreasing utilizing screening among males. The study concludes that the utilization of CVD risk factor screening among males during past year is below 50% in Kokkuvil PHI area. Utilization is affected by the age group that a male belongs to, employment type, knowledge about CVD, his tobacco consumption, and vegetable intake Therefore, health education and promotion programs targeting improving knowledge and modifying healthy behaviors will be effective in improving male screening utilization for CVD risk factors.