INTRODUCTION:

Cardiovascular diseases (CVDs) are the chief cause of death globally.¹In 2017, CVD leads 17.8 million deaths worldwide; of which 80% occurred only in low and middle-income countries (LMICs).²It is projected that by the year 2030, More than 23.6 million people will die as a result of CVDs.³

In 2017, Ethiopia’s population was estimated at 104 million, in which 41 percentof the population is under the age of 15. More than 28 percent are aged 15 to 29.⁴

Young adults' cardiovascular disease morbidity is developing while mortality is falling.⁵Young adulthood (generally defined as 18 to 22 or 18 to 25).⁶

Hypertension and hyperlipidemia inyounger adulthoodare linked to later-life coronary heart disease (CHD). Age, sex, ethnicity, and others are the key risk factors for CHD reported in the literature.⁷

Risk factors such as smoking, physical inactivity, unhealthy eating, overweight are increasing the burden of CVDs in LMICs.⁸Physical inactivity is a well-known risk factor for cardiovascular disease, which is the world's fourth leading cause of death.⁹ An extensive survey (2003 to 2009) on the physical activity levels of individuals aged between 25 to 64 years around 22 African countries mentioned that African men and women were no more active than Asian, European, and North American cohorts.¹⁰

In developed countries, controlling of risk factors such as blood pressure, total cholesterol, smoking, and physical inactivity managed to a substantial decrease in CVD-related morbidity and mortality.¹¹An individual's overall cardiovascular risk may be reduced if they are aware of CVD risk factors. According to the health belief model (HBM), a person must feel susceptible to a disease to be motivated for a change in behaviour.¹²

The public's understanding of risk factors is a critical first step toward reducing CVDs and improving cardiovascular health.¹³Individual attitudes and behaviors toward a healthy lifestyle can be influenced.¹⁴By Improved patient adherence and a lower risk of disease complications.¹⁵Since the lifestyles associated with relevant risk factors are modifiable through political action, their extent should be known by public health authorities to enable them to take counteractive measures timely.¹⁶Rising of heart related disease among young adults will put pressure on the nation’s healthcare system economically. There is a need for awareness of cardiovascular disease in this population group.⁵

Methods:

The study will be conducted at Bule Hora town which is located in the West guji zone Southern Ethiopia Oromia regional state. This town found in the southern direction of the Capital city Addis Ababa around 470KM. In Bule Hora town, According to 2013 E.C, based on a zonal office record in Bule Hora town, the total estimated population is 59,024. From the total population, the estimated younger adults were 11,662. Bule Hora town was divided into three areas with a population of 23,339, 8595, and, 27090 respectively.

A community-based descriptive study was conducted from January 2021 to February 2021 among younger adults between the age group of 18 to 24 years at Bule Hora Town.

The sample size is determined using the standard formula for a single population proportion by taking 50%. From the formula, the sample size was 196. After adding 10% of non-respondent, the final sample size is 216. The systematic simple random technique was used to collect data; first area wise younger adult houses were mapped by survey method. Finally, based on the k^th formula every 54th house was labelled and data were collected.

The data collected using pretested, structured, and semi-structured self-administered questionnaires. The questionnaire has three parts: Part I: Socio-demographic characters, Part II: structured Knowledge assessment questionnaire will contain 30 questions, each correct response coded with 1 and wrong 0. Part III: Likert scale to assess the attitude level contains 10 questions, each favorable attitude scored 5 and unfavorable 0. It was prepared in English and Afan Oromo language and was reviewed by a language expert. Four BSc nurses for data collection and one MSc nurse for supervision of the data collection were recruited in this study. The study assistants were trained for two days intensively.

During data collection, each respondent invited to participate in the study voluntarily and also be able to stop participation when necessary. The questionnaire was distributed and they were asked to return the filled questionnaire to data collectors within 24 hours. The supervisors have checked questionnaires for completeness.

The quality of the data assured by using standard, pre-tested questionnaires and proper data collection procedures. Prior to the actual data collection, pre-testing was done on 5% (11) of the total study subjects at Gerba village; which was not be included in the actual study and based on the findings necessary amendments made regarding its consistency, clarity, and logical adequacy and time it takes to complete Questionnaire.

The data coded, checked for error, the missing value must be dealt with, and cleaned data (edited) entered into Epi-Data version 4.4.3.1 and exported to SPSS Statistics Version 25 for analysis. The results of descriptive statistics summarized and presented by tables, charts, and graphs. Percentage, frequency, and mean were calculated. A correlation test and chi-square test were also d

RESULT:

Socio-demographic Variable of young adults:

In this study, the most of the younger adult between the age group of (24-26) nearly 40%. The highest study participant was female about 53% and unmarried about 57%. Religious group nearby 50% belongs to protestant. Monthly income (1001-2000 birr) of the family was 46%. Regarding education, nearly 42 % had finished their schooling and next nearly 40 % of study participant were illiterate. Occupation shows that nearly 30% were unemployed and 30% were working for daily wages. Regarding sources of information about cardiovascular risks from friends and health care workers were about 30% respectively. (See table 1)

Table 1: Socio-demographic Variable of young adults in BuleHora town, Ethiopia:

Demographic Variables	Frequencies	Percentage
Demographic Variables	F	%
1.Age in Years
a. 18-20	65	30
b. 21-23	68	31
c. 24-26	83	39
2.Gender
a. Female	115	53
b. Male	101	47
3. Marietal Status
a. Married	94	43
b. Unmarried	122	57
4.RELIGION
a. Protestant	104	48
b. Orthodox	65	30
c. Muslim	47	22
5.Family Income/Month
a. 1001-2000 birr	101	46
b. 2001-3000 birr	58	27
c. 3001 to 4000 birr	36	17
d. Above 5000 birr	22	10
6. Education
a. Illiterate	83	38
b. School level education	90	42
c. University education	43	20
7. Occupation
a. Unemployed	65	30
b. Coolie	43	20
c. Self-employed	43	20
d. Others	65	30
8. Sources of Information
a. Friends	65	30
b. Any health workers	65	30
c. Parents	36	17
d. Health magazines	50	23

Overall knowledge of young adults about cardiovascular risk:

The overall knowledge of young adult about cardiovascular risk is moderate (63%) and (20%) were have poor knowledge and the remaining (17%) had good knowledge. (Figure 1)

The overall attitude of young adults about cardiovascular risk:

The overall attitude of young adult about cardiovascular risk is neutral (52%) and (23%) were have unfavourable attitude and the remaining (25%) had a favourable attitude. (Figure 2)

Correlation between knowledge and attitude of young adults about cardiovascular risk:

In this study there was a positive moderate correlation (r = 0.7) between knowledge and attitude among young adults about cardiovascular risk, mean knowledge value is 15.3 (SD=5.02) and means attitude value is 27.25 (SD=10.25). (See table 2).

Table 2: Correlation between knowledge and attitude of young adults about cardio vascular risk in BuleHora town, Ethiopia:-

Variables	Mean Value	SD	Correlation
			(moderate positive correlation)
Knowledge	15.03	5.02	0.67138
Attitude	27.25	10.25

Association between knowledge and selected socio-demographic variable:-

There was no significant association between knowledge with their selected socio-demographic variables of younger adults about cardiovascular risk. (See table 3)

Table 3: Association between knowledge and selected socio-demographic variable of younger adult regarding cardio vascular risk in BuleHora town, Ethiopia:

Sl. NO	Demographic Variables	Level of Knowledge			Total	ᵪ2	Df	Inferences
Sl. NO	Demographic Variables	Poor	M	Good	Total	ᵪ2	Df	Inferences
1)	Age in Years
	a. 18-20	11	43	11	65	1.4739	4	N.S (p=0.8312)
	b. 21-23	18	36	14	68		4
	c. 24-26	14	58	11	83
2)	Gender
	a. Female	25	58	32	115	0.3672	2	N.S (p=0.8322)
	b. Male	25	54	22	101			N.S (p=0.8322)
3)	Marietal Status
	a. Married	22	47	25	94	0.0938	2	N.S (p=0.95432)
	b. Unmarried	28	65	29	122			N.S (p=0.95432)
4)	RELIGION
	a. Protestant	25	54	25	104			N.S (p=0.9982)
	b. Orthodox	14	32	18	64	0.123	4
	c. Muslim	11	25	12	48
5)	Family Income/Month
	a. 1001-2000 birr	14	72	14	100			N.S (p=0.7198)
	b. 2001-3000 birr	14	36	8	58	3.6807	6
	c. 3001 to 4000 birr	7	22	7	36
	d. Above 5000 birr	7	8	7	22
6)	Education
	a. Illiterate	22	54	7	83	13.047	4	N.S (p=0.0109)
	b. School level education	14	68	8	90
	c. University education	7	14	22	43
7)	Occupation
	a. Unemployed	11	43	11	65	2.4269	6	N.S (p=0.8765)
	b. Coolie	7	32	5	44
	c. Self-employed	7	29	7	43
	d. Others	18	32	14	64
8)	Sources of Information
	a. Friends	14	40	11	65	0.6222	6	N.S (p=0.9960)
	b. Any health workers	14	40	11	65
	c. Parents	7	22	7	36
	d. Health magazines	7	36	7	50

N.S-Not Significant; P-Poor Knowledge; M-Moderate Knowledge; G-Good Knowledge

Table 4: Association between attitude and selected socio-demographic variable of young adult regarding cardio vascular risk in BuleHora town, Ethiopia:-

Sl. No	Demographic Variables	Level of Attitude			Total	ᵪ2	Df	Inferences
Sl. No	Demographic Variables	UF	N	F	Total	ᵪ2	Df	Inferences
1)	Age in years
	a. 18-20	14	40	11	65			N.S
	b. 21-23	14	36	18	68	1.5242	4	(p=0.8223)
	c. 24-26	22	36	25	83
2)	Gender							N.S
	a. Female	25	58	32	115	0.3672	2	(p=0.8322)
	b. Male	25	54	22	101
3)	Marietal Status
	a. Married	22	47	25	94	0.0938	2	N.S
	b. Unmarried	28	65	29	122			(p=0.95432)
4)	Religion
	a. Protestant	25	54	25	104			N.S
	b. Orthodox	14	32	18	64	0.123	4	(p=0.9982)
	c. Muslim	12	25	11	48
5)	Family Income/Month
	a. 1001-2000 birr	14	72	14	100			N.S
	b. 2001-3000 birr	14	36	7	57	3.6807	6	(p=0.7198)
	c. 3001 to 4000 birr	7	22	7	36
	d. Above 5000 birr	8	8	7	23
6)	Education
	a. Illiterate	18	47	18	83	1.4578	4	N.S
	b. School level education	22	40	28	90			(p=0.8341)
	c. University education	11	25	7	43
7)	Occupation
	a. Unemployed	18	32	14	64	3.3474	6	N.S
	b. Coolie	11	39	4	54			(p=0.7641)
	c. Self-employed	7	22	14	43
	d. Others	14	29	22	65
8)	Sources of Information
	a. Friends	14	36	14	64	1.7955	6	N.S
	b. Any health workers	18	25	22	65			(p=0.9375)
	c. Parents	7	22	7	36
	d. Health magazines	11	29	11	51

N.S-Not Significant; UF-Unfavourable Attitude; N-Neutral Attitude; F-Favourable Attitude

DISCUSSION:

In this study, the main sources of information about cardiovascular risk were from friends and health care workers and from parents and health magazines least mentioned. Similar study in Tanzania, reported that cardiovascular disease information from relatives/ neighbours, radio, other health care providers and doctors.¹⁷In both studies, the source of information relatively the same is due to this population living in a rural setting.

Most of the study population in this study had a very moderate level of knowledge about cardiovascular risk was 63% and only 17% had good knowledge. A similar study in India noted that most of the younger adult had very less knowledge regarding cardiovascular diseases is about 50%.¹⁸Another study among Ethiopian university student about knowledge on cardiovascular risk factor mentioned that 32.2% of participants had good knowledge (scored 70% and above).¹⁹This difference may because of the source of information exposed or due to the educational status of study participant. Another review of literature mentioned that lack of knowledge regarding CVD risk factors, treatment, and control rates are worse among young adults between the ages of 20 and 39 years.⁷

In this study, 50% of younger adult had a neutral attitude regarding cardiovascular risk and about 27% had a favourable attitude. Study from India, younger adult reported that 37.6% of individuals had a negative attitude, followed by 35.2% with a neutral and 27.2% having a positive attitude.¹⁸Almost in both study attitude of younger adult about cardiovascular risk was the same. On another hand study from Ethiopian Gondar university student’s perception about cardiovascular risk factor was higher (61.2%).¹⁹This study result difference may due to educational status or from the source of information of study participant. Another finding from a systematic review study from SSA (Sub Saharan Africa) indicated low levels of knowledge coupled with unfavourable perception towards CVD risk.²⁰

A systemic review done in 2018, concluded that young adults demonstrate limited knowledge and poor attitudes regarding cardiovascular disease and its risk factors and urge need to build knowledge of cardiovascular risk identification in this population group.⁵

In this study there was a positive moderate correlation (r = 0.7) between knowledge and attitude among young adults about cardiovascular risk was found, the mean knowledge value is 15.3 (SD=5.02) and mean attitude value is 27.25 (SD=10.25). Similarly, an Indian study on young adult shows that knowledge was found to be a highly significant association with attitude (r=0.616, p<.01) about cardiovascular disease.¹⁸

ACKNOWLEDGMENTS:

We appreciate the contributions of both study participants and data collectors to the success of our research.

COMPETING INTERESTS:

There are no competing financial interests declared by any individual or organization in this manuscript, nor are there any competing non-financial interests such as political, medical, religious, ideological, scholarly, intellectual, commercial, or other.

AUTHORS’ CONTRIBUTIONS:

All authors and co-authors were involved in the data analysis and manuscript preparation, as well as conceived and planned the report, analyzed the data, wrote the manuscript, drafted the manuscript, and advising the entire research paper. Similarly, the final version of the manuscript has been read and accepted by all contributors.

ETHICAL APPROVAL:

Ethical clearance obtained from concerned authority from university.

CONSENT:

A well-informed written consent was obtained from each research participant.

CONFLICT OF INTEREST:

There is no conflict of interest on the publication of this research paper.

DUPLICATED PUBLICATION:

The authors confirm that the manuscript is original, has not already been published in a journal, and is not currently under consideration by another journal.

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Received on 16.10.2023 Modified on 13.11.2023

Asian J. Nursing Education and Research. 2024; 14(1):57-62.

DOI: 10.52711/2349-2996.2024.00011