{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:26:33Z","timestamp":1792074393193,"version":"4.4.0"},"reference-count":33,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T00:00:00Z","timestamp":1667520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Commission through the Horizon 2020","award":["733356"],"award-info":[{"award-number":["733356"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>The rise in non-communicable diseases (NCDs) has been attributed to economic growth in developing countries, shifts in societal norms, and behaviors such as dietary habits and physical activity. Up to 80% of NCDs could be prevented by eliminating shared risk factors, mainly tobacco use, unhealthy diets, physical inactivity, and the harmful use of alcohol. The South African government\u2019s national strategic plan to control NCDs, which includes cardiovascular disease (CVD) prevention, places a strong emphasis on the need to improve the prevention, detection, early intervention, and management of NCDs. In line with the above recommendations, this study aimed to screen rural communities using the non-laboratory INTERHEART Risk Score tool (NLIRS) and develop relevant and suitable intervention strategies for a patient at moderate risk of developing a heart attack. A quantitative research approach applying a household-based design was used to conduct this study and the community action model (CAM). The difference between pre-intervention and post-intervention results were analyzed using a t-test and Analysis of covariance (ANCOVA) with age, smoke, hypertension, and diabetes as the covariates. The study found a significant difference in proportions between pre and post-intervention for raised Systole (SBP), obesity by body mass index (BMI), and waist circumference (WC). In rural communities, using CAM to improve knowledge and behavioral practices of NCD risk factors is feasible and effective. This basket of interventions will assist community members in reducing their risk of developing metabolic syndromes as well as their risk of developing CVDs. Continued investment and research in CVD prevention interventions are required to improve health, reduce costs, and have long-term benefits for conflict-affected individuals and communities.<\/jats:p>","DOI":"10.3390\/metabo12111067","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T09:20:27Z","timestamp":1667553627000},"page":"1067","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Screening and Interventions for Cardiovascular Disease Prevention in the Limpopo Province, South Africa: Use of the Community Action Model"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3068-9406","authenticated-orcid":false,"given":"Peter M.","family":"Mphekgwana","sequence":"first","affiliation":[{"name":"Research Administration and Development, University of Limpopo, Polokwane 0700, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotsedi D.","family":"Monyeki","sequence":"additional","affiliation":[{"name":"Department of Physiology and Environmental Health, University of Limpopo, Polokwane 0700, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8577-9126","authenticated-orcid":false,"given":"Tebogo M.","family":"Mothiba","sequence":"additional","affiliation":[{"name":"Faculty of Health Science, University of Limpopo, Polokwane 0700, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4973-5692","authenticated-orcid":false,"given":"Mpsanyana","family":"Makgahlela","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Limpopo, Polokwane 0700, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Kgatla","sequence":"additional","affiliation":[{"name":"Department of Nursing Science, University of Limpopo, Polokwane 0700, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rambelani N.","family":"Malema","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Limpopo, Polokwane 0700, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tholene","family":"Sodi","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Limpopo, Polokwane 0700, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,4]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2022, July 28). Non Communicable Diseases. Who.int. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/noncommunicable-diseases."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"020409","DOI":"10.7189\/jogh.09.020409","article-title":"Non-communicable diseases in sub-Saharan Africa: A scoping review of large cohort studies","volume":"9","author":"Mudie","year":"2019","journal-title":"J. Glob. Health"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Peer, N., Steyn, K., Lombard, C., Gwebushe, N., and Levitt, N. (2013). A high burden of hypertension in the urban black population of Cape Town: The Cardiovascular Risk in Black South Africans (CRIBSA) Study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0078567"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Holmes, M.D., Dalal, S., Volmink, J., Adebamowo, C.A., Njelekela, M., Fawzi, W.W., Willett, W.C., and Adami, H.O. (2010). Non-communicable diseases in sub-Saharan Africa: The case for cohort studies. PLoS Med., 7.","DOI":"10.1371\/journal.pmed.1000244"},{"key":"ref_5","first-page":"349312","article-title":"Management of chronic diseases in sub-Saharan Africa: Cross-fertilisation between HIV\/AIDS and diabetes care","volume":"2012","author":"Schellevis","year":"2012","journal-title":"J. Trop. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"436","DOI":"10.7196\/SAMJ.2016.v106i5.10776","article-title":"Persistent burden from non-communicable diseases in South Africa needs strong action","volume":"106","author":"Nojilana","year":"2016","journal-title":"S. Afr. Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e177","DOI":"10.1016\/S2214-109X(18)30476-5","article-title":"Urgency for South Africa to prioritise cardiovascular disease management","volume":"7","author":"Schutte","year":"2019","journal-title":"Lancet Glob. Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2048004016687211","DOI":"10.1177\/2048004016687211","article-title":"Primary prevention of cardiovascular disease: A review of contemporary guidance and literature","volume":"6","author":"Stewart","year":"2017","journal-title":"JRSM Cardiovasc. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1080\/14779072.2016.1176528","article-title":"Epidemiology of cardiovascular disease: Recent novel outlooks on risk factors and clinical approaches","volume":"14","author":"Niiranen","year":"2016","journal-title":"Expert Rev. Cardiovasc. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.ihj.2015.07.004","article-title":"Risk assessment in the prevention of cardiovascular disease in low-resource settings","volume":"68","author":"Ofori","year":"2016","journal-title":"Indian Heart J."},{"key":"ref_11","unstructured":"World Health Organization (2022, July 28). WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care. Who.int. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/334186\/9789240009226-eng.pdf?sequence=1."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/inthealth\/ihy063","article-title":"Non-communicable diseases: Ditch the label and recapture public awareness","volume":"11","author":"Blundell","year":"2019","journal-title":"Int. Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1161\/CIRCULATIONAHA.110.009522","article-title":"Promoting global cardiovascular health: Moving forward","volume":"123","author":"Fuster","year":"2011","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S0140-6736(14)61682-2","article-title":"Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"385","author":"Abubakar","year":"2015","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/S0140-6736(13)60687-X","article-title":"Chronic kidney disease: Global dimension and perspectives","volume":"382","author":"Jha","year":"2013","journal-title":"Lancet"},{"key":"ref_16","unstructured":"Msemburi, W., Pillay-van Wyk, V., Dorrington, R.E., Neethling, I., Nannan, N., Groenewald, P., and Bradshaw, D. (2014). Second national burden of disease study for South Africa: Cause-of-death profile for South Africa, 1997\u20132010. Cape Town S. Afr. Med. Res. Counc., 1\u201323."},{"key":"ref_17","unstructured":"Z\u0171hlke, L. (2022, July 28). Why Heart Disease Is on the Rise in South Africa. Available online: http:\/\/theconversation.com\/why-heart-disease-is-on-the\u2013rise-in-south-afric-66167."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1377\/hlthaff.26.1.13","article-title":"Reducing the growing burden of cardiovascular disease in the developing world","volume":"26","author":"Gaziano","year":"2007","journal-title":"Health Aff."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s12910-018-0288-z","article-title":"Integrated primary health care in low-and middle-income countries: A double challenge","volume":"19","author":"Druetz","year":"2018","journal-title":"BMC Med. Ethics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1472-6963-13-S2-S1","article-title":"Strengthening integrated primary health care in Sofala, Mozambique","volume":"13","author":"Sherr","year":"2013","journal-title":"BMC Health Serv. Res."},{"key":"ref_21","first-page":"574111","article-title":"Management and prevention strategies for non-communicable diseases (NCDs) and their risk factors","volume":"788","author":"Aida","year":"2020","journal-title":"Front. Public Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"331","DOI":"10.7196\/SAMJ.2017.v107i4.11438","article-title":"Available data sources for monitoring non-communicable diseases and their risk factors in South Africa","volume":"107","author":"Wandai","year":"2017","journal-title":"S. Afr. Med. J."},{"key":"ref_23","unstructured":"Hofman, K.J., and Lee, R. (2022, July 28). Intersectoral case study: Successful sodium regulation in South Africa. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/205179\/9789290232339.pdf."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s11739-016-1423-9","article-title":"Cardiovascular disease and hypertension in sub-Saharan Africa: Burden, risk and interventions","volume":"11","author":"Cappuccio","year":"2016","journal-title":"Intern. Emerg. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12872-021-02290-1","article-title":"Facilitators and barriers in prevention of cardiovascular disease in Limpopo, South Africa: A qualitative study conducted with primary health care managers","volume":"21","author":"Douglas","year":"2021","journal-title":"BMC Cardiovasc. Disord."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"241","DOI":"10.2174\/1874944502114010241","article-title":"Community-Based Screening for Cardiovascular Disease in the Capricorn District of Limpopo Province, South Africa","volume":"14","author":"Malema","year":"2021","journal-title":"Open Public Health J."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mphekgwana, P.M., Malema, N., Monyeki, K.D., Mothiba, T.M., Makgahlela, M., Kgatla, N., Makgato, I., and Sodi, T. (2020). Hypertension Prevalence and Determinants among Black South African Adults in Semi-Urban and Rural Areas. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17207463"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1093\/eurheartj\/ehq448","article-title":"Estimating modifiable coronary heart disease risk in multiple regions of the world: The INTERHEART Modifiable Risk Score","volume":"32","author":"McGorrian","year":"2011","journal-title":"Eur. Heart J."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Chan, N.P.T., Tarrant, M., Ngan, E., So, H.K., Lok, K.Y.W., and Nelson, E.A.S. (2018). Agreement between self-\/home-measured and assessor-measured waist circumference at three sites in adolescents\/children. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0193355"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/MBP.0b013e3283360e98","article-title":"European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults","volume":"15","author":"Atkins","year":"2010","journal-title":"Blood Press. Monit."},{"key":"ref_32","first-page":"1009","article-title":"World Health Organization-International Society of Hypertension Guidelines for the management of hypertension. Guidelines sub-committee of the World Health Organization","volume":"21","author":"Chalmers","year":"1999","journal-title":"Clin. Exp. Hypertens."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e434","DOI":"10.1016\/S2589-7500(21)00079-0","article-title":"Association between change in cardiovascular risk scores and future cardiovascular disease: Analyses of data from the Whitehall II longitudinal, prospective cohort study","volume":"3","author":"Lindbohm","year":"2021","journal-title":"Lancet Digit. Health"}],"container-title":["Metabolites"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-1989\/12\/11\/1067\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:10:36Z","timestamp":1760145036000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-1989\/12\/11\/1067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,4]]},"references-count":33,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["metabo12111067"],"URL":"https:\/\/doi.org\/10.3390\/metabo12111067","relation":{},"ISSN":["2218-1989"],"issn-type":[{"value":"2218-1989","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,4]]}}}