Abstract
Introduction: Cardiovascular disease is the primary cause of mortality worldwide and a major contributor to reduced quality of life. Saudi women are potentially at a greater risk than a decade ago to develop CVD and diabetes mellitus, with a notable increase in obesity and physical inactivity compared to men. Secondary prevention initiatives, including dietary modifications, offer an evidence-based approach for preventing CVD and reducing mortality and morbidity among women.
Aim: This study aims to explore the barriers and motivators in adhering to healthy diets from the perspectives of Saudi women Living with Cardiovascular Disease. A secondary aim is to uncover the role of gender in food choices.
Methods: A qualitative descriptive design using individual semi-structured interviews were conducted with 19 Saudi women. Analysis followed Braun and Clarke's thematic analysis approach.
Results: This study highlighted the barriers faced by women living with CVD regarding adherence to a heart-healthy diet due to gender roles limitations as housewives. The disease prognosis appeared as the main motivator for adopting a healthy lifestyle. Moreover, sufficient motivation from family members, receiving diet guidance from healthcare professionals, strong willingness and self-control appeared to be the most common motivators.
Conclusion: Adhering to a heart-healthy diet is a very complex behavior that is often influenced by a variety of multilevel factors. This study highlighted the crucial need to addressing key barriers. It also can inform the development of tailored program targeted to women in Saudi Arabia.
Notes
References:
Ahmed, A. M., Hersi, A., Mashhoud, W., Arafah, M. R., Abreu, P. C., Al Rowaily, M. A., & Al-Murayeh, M. A. (2017). Cardiovascular risk factors burden in Saudi Arabia: The Africa Middle East Cardiovascular Epidemiological (ACE) study. Journal of the Saudi Heart Association, 29(4), 235–243. https://doi.org/10.1016/j.jsha.2017.03.004
Alhabib, K. F., Batais, M. A., Almigbal, T. H., Alshamiri, M. Q., Altaradi, H., Rangarajan, S., & Yusuf, S. (2020). Demographic, behavioral, and cardiovascular disease risk factors in the Saudi population: Results from the Prospective Urban Rural Epidemiology study (PURE-Saudi). BMC Public Health, 20(1), Article 1213.
Alshaikh, M. K., Filippidis, F. T., Baldove, J. P., Majeed, A., & Rawaf, S. (2016). Women in Saudi Arabia and the prevalence of cardiovascular risk factors: A systematic review. Journal of Environmental and Public Health, 2016, Article 7479357. https://doi.org/10.1155/2016/7479357
Alshaikh, M. K., Baldove, J. P., Rawaf, S., Alarifi, M. I., & Alzeer, A. H. (2022). Health beliefs and cardiovascular risk among Saudi women: A cross sectional study. Family Medicine and Primary Care: Open Access, 6(3).
Barolia, R., Petrucka, P., Higginbottom, G. A., Khan, F. F. S., & Clark, A. M. (2019). Motivators and deterrents to diet change in low socio-economic Pakistani patients with cardiovascular disease. Global Qualitative Nursing Research, 6, Article 233339361988360.
Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., & American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2019). Heart disease and stroke statistics—2019 update: A report from the American Heart Association. Circulation, 139(10), e56-e528.
Berumen, A. (2021). Promoting cardiovascular health: Addressing barriers to implementing the Mediterranean diet. escholarship.org.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.
Brinks, J., Fowler, A., Franklin, B. A., & Dulai, J. (2016). Lifestyle modification in secondary prevention. American Journal of Lifestyle Medicine, 11(2), 137-152.
Castillo-Mayén, R., Cano-Espejo, C., Luque, B., Cuadrado, E., Gutiérrez-Domingo, T., Arenas, A., Rubio, S. J., Delgado-Lista, J., Pérez-Martínez, P., & Tabernero, C. (2020). Influence of self-efficacy and motivation to follow a healthy diet on life satisfaction of patients with cardiovascular disease: A longitudinal study. Nutrients, 12(7), Article 1903. https://doi.org/10.3390/nu12071903
Creswell, J. W., & Poth, C. N. (2016). Qualitative inquiry & research design: Choosing among five approaches (4th ed.). Sage.
Diab, A., Dastmalchi, L. N., Gulati, M., & Michos, E. D. (2023). A heart-healthy diet for cardiovascular disease prevention: Where are we now? Vascular Health and Risk Management, 19, 237-253. https://doi.org/10.2147/VHRM.S379874
Espejo, M., Magabo, S., Rivera-Castro, A., Faiz, M., Ramirez, L., Robles, C., & Joseph, J. (2018). Qualitative study of knowledge, perception, and behavior related to hypertension and cardiovascular disease risk reduction among hypertensive African-Americans in urban inner city of South Bronx, New York. Journal of Racial and Ethnic Health Disparities, 6(1), 197-206.
Fongkaew, W., Rahman, F., Pinyokham, N., & Tachaudomdach, C. (2018). Barriers and facilitators related to heart-healthy lifestyle among persons with acute coronary syndrome. Pacific Rim International Journal of Nursing Research, 22(3), 249-263.
General Authority for Statistics. (2018, November 21). GASTAT: Saudi workers monthly average wage in four sectors: 10.238 SAR. https://www.stats.gov.sa/en/news/292
James, A., Lawrence, B., & O'Connor, M. (2022). Healthy eating as a new way of life: A qualitative study of successful long-term diet change. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 59.
Kalantarzadeh, M., Yousefi, H., Alavi, M., & Maghsoudi, J. (2022). Adherence barriers to treatment of patients with cardiovascular diseases: A qualitative study. Iranian Journal of Nursing and Midwifery Research, 27(4), 317-324.
Kim, H., Sefcik, J. S., & Bradway, C. (2017). Characteristics of qualitative descriptive studies: A systematic review. Research in Nursing & Health, 40(1), 23-42.
Lichtenstein, A. H., Appel, L. J., Vadiveloo, M., Hu, F. B., Kris-Etherton, P. M., Rebholz, C. M., Wylie-Rosett, J., & Horn, L. V. (2021). 2021 dietary guidance to improve cardiovascular health: A scientific statement from the American Heart Association. Circulation, 144(23).
Lu, L., Jing, W., Qian, W., Fan, L., & Cheng, J. (2024). Association between dietary patterns and cardiovascular diseases: A review. Current Problems in Cardiology, Article 102412.
McLean, R. M., Xie, Z., Nelson, V., Nosa, V., Thein, H., Po'e-Tofaeono, A., & Drummond, S. (2021). Experiences of New Zealand haemodialysis patients in relation to food and nutrition management: A qualitative study. Nutrients, 13(7), Article 2299.
Pinho, M. G., Mackenbach, J. D., Charreire, H., Oppert, J. M., Bárdos, H., Glonti, K., & Lakerveld, J. (2017). Exploring the relationship between perceived barriers to healthy eating and dietary behaviours in European adults. European Journal of Nutrition, 57(5), 1761-1770.
Rashed, M., Theruvan, N., Gad, A., Shaheen, H., & Mosbah, S. (2020). Cardiac rehabilitation: Future of heart health in Saudi Arabia, a perceptual view. World Journal of Cardiovascular Diseases, 10(09), 666-677.
Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., & Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: A systematic analysis for the global burden of disease study 2017. The Lancet, 392(10159), 1736-1788.
Sandelowski, M. (2009). What's in a name? Qualitative description revisited. Research in Nursing & Health, 33(1), 77-84.
Seixas, A., Connors, C., Chung, A., Donley, T., & Jean-Louis, G. (2020). A pantheoretical framework to optimize adherence to healthy lifestyle behaviors and medication adherence: The use of personalized approaches to overcome barriers and optimize facilitators to achieve adherence. JMIR mHealth and uHealth, 8(6), Article e16429.
Shan, Z., Li, Y., Baden, M. Y., Bhupathiraju, S. N., Wang, D. D., Sun, Q., & Hu, F. B. (2020). Association between healthy eating patterns and risk of cardiovascular disease. JAMA Internal Medicine, 180(8), 1090-1100.
Stevenson, J., Tong, A., Gutman, T., Campbell, K. L., Craig, J. C., Brown, M. A., & Lee, V. W. (2018). Experiences and perspectives of dietary management among patients on hemodialysis: An interview study. Journal of Renal Nutrition, 28(6), 411-421.
Sterling, M. R., Silva, A. F., Robbins, L., Dargar, S. K., Schapira, M. M., & Safford, M. M. (2018). Let's talk numbers: A qualitative study of community-dwelling US adults to understand the role of numeracy in the management of heart failure. BMJ Open, 8(9).
Stokes-Walters, R., Fofana, M. L., Songbono, J. L., Barry, A. O., Diallo, S., Nordhagen, S., & Ruel, M. (2021). "If you don't find anything, you can't eat" – Mining livelihoods and income, gender roles, and food choices in Northern Guinea. Resources Policy, 70, Article 101939.
Tunsi, A., Chandler, C., & Holloway, A. (2023). Perspectives on barriers and facilitators to lifestyle change after cardiac events among patients in Saudi Arabia: A qualitative study. European Journal of Cardiovascular Nursing, 22(2), 201-209.
Varì, R., Scazzocchio, B., D'Amore, A., Giovannini, C., Gessani, S., & Masella, R. (2016). Gender-related differences in lifestyle may affect health status. Annali dell'Istituto Superiore di Sanita, 52(2), 158-166.
Virani, S. S., Smith, S. C., Stone, N. J., & Grundy, S. M. (2020). Secondary prevention for atherosclerotic cardiovascular disease. Circulation, 141(14), 1121-1123.
Wahabi, H., Esmaeil, S., Zeidan, R., Jamal, A., & Fayed, A. A. (2023). Age and gender-specific pattern of cardiovascular disease risk factors in Saudi Arabia: A subgroup analysis from the Heart Health Promotion Study. Healthcare, 11(12). https://doi.org/10.3390/healthcare11121737
World Health Organization. (2018). Noncommunicable diseases country profiles 2018. WHO.
Xia, S., Du, X., Guo, L., Du, J., Arnott, C., Lam, C. S. P., & Wang, L. (2020). Sex differences in primary and secondary prevention of cardiovascular disease in China. Circulation, 141(7), 530-539.
Yu, E., Malik, V. S., & Hu, F. B. (2018). Cardiovascular disease prevention by diet modification. Journal of the American College of Cardiology, 72(8), 914-926.
Sigma Membership
Alpha Beta Sigma at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Descriptive/Correlational
Research Approach
Qualitative Research
Keywords:
Public and Community Health, Health Equity, Social Determinants of Health, Interprofessional Initiatives, Clinical Practice, Health Promotion, Disease Prevention, Diet, Cardiovascular Disease, Saudi Women
Recommended Citation
Alghamdi, Rahaf Abdullah; Tunsi, Afnan Yousef; Sallam, Lujain Adel; Sinnari, Reem Abdulsalam; Assiri, Raghad Mueed; Alafghani, Rahaf Abdulrazaq; and Tammar, Anwar Mustafa, "Barriers and Motivators to Diet Change in Saudi Women Living with Cardiovascular Disease" (2025). Biennial Convention (CONV). 72.
https://www.sigmarepository.org/convention/2025/presentations_2025/72
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-20
Barriers and Motivators to Diet Change in Saudi Women Living with Cardiovascular Disease
Indianapolis, Indiana, USA
Introduction: Cardiovascular disease is the primary cause of mortality worldwide and a major contributor to reduced quality of life. Saudi women are potentially at a greater risk than a decade ago to develop CVD and diabetes mellitus, with a notable increase in obesity and physical inactivity compared to men. Secondary prevention initiatives, including dietary modifications, offer an evidence-based approach for preventing CVD and reducing mortality and morbidity among women.
Aim: This study aims to explore the barriers and motivators in adhering to healthy diets from the perspectives of Saudi women Living with Cardiovascular Disease. A secondary aim is to uncover the role of gender in food choices.
Methods: A qualitative descriptive design using individual semi-structured interviews were conducted with 19 Saudi women. Analysis followed Braun and Clarke's thematic analysis approach.
Results: This study highlighted the barriers faced by women living with CVD regarding adherence to a heart-healthy diet due to gender roles limitations as housewives. The disease prognosis appeared as the main motivator for adopting a healthy lifestyle. Moreover, sufficient motivation from family members, receiving diet guidance from healthcare professionals, strong willingness and self-control appeared to be the most common motivators.
Conclusion: Adhering to a heart-healthy diet is a very complex behavior that is often influenced by a variety of multilevel factors. This study highlighted the crucial need to addressing key barriers. It also can inform the development of tailored program targeted to women in Saudi Arabia.
Description
A qualitative descriptive approach explored Barriers and Motivators to Diet Change in Saudi Women Living with Cardiovascular Disease. Findings offered an insight into individual, social, institutional, and environmental factors that played as barriers/motivators among women who modified their diets following cardiac events. This in-depth exploration can inform the development of tailored programs aimed at Saudi women ultimately reducing mortality associated with CVD and improving health outcomes.