Authors: Dr Nilani Sammuarachchi
Abstract: Cardiovascular disease (CVD) and stroke remain the leading causes of mortality and long-term disability worldwide, representing a critical and escalating public health challenge. Despite significant advances in medical treatment and diagnostic technologies, the global burden of CVD and stroke continues to rise, largely driven by preventable and modifiable risk factors including diabetes mellitus, unhealthy lifestyle behaviours, psychological stress, and inadequate community awareness of prevention and early intervention strategies. These factors disproportionately affect vulnerable and high-risk populations, contributing to persistent health inequities and increasing strain on healthcare systems. This doctoral research examined strategies for reducing cardiovascular disease and stroke risk through an integrated public health framework encompassing diabetes control, lifestyle modification, psychological wellbeing, and community-based health education. A TAP-IT mixed-methods research design was adopted to integrate quantitative and qualitative evidence, enabling a comprehensive examination of biomedical risk factors alongside behavioural patterns, psychosocial experiences, and community-level influences. Quantitative data were collected using structured questionnaires to assess diabetes status, cardiovascular risk profiles, lifestyle behaviours, psychological stress, and awareness of cardiovascular disease and stroke prevention. Qualitative data were obtained through semi-structured interviews, capturing participants lived experiences, emotional challenges, health beliefs, and perceived barriers and facilitators to preventive behaviour change. The study identified critical gaps in diabetes management, sustained lifestyle adoption, psychological coping capacity, and community health literacy related to cardiovascular disease and stroke prevention. The integrated findings informed the development of a conceptual public health prevention framework that highlights the interdependent roles of metabolic control, behavioural modification, psychological support, and community engagement. By adopting a holistic and people-centred public health perspective, this research contributes evidence to support the design of culturally responsive, community-focused prevention strategies, strengthen cardiovascular and stroke prevention programmes, enhance patient and community engagement, and ultimately reduce long-term cardiovascular risk at both individual and population levels.
DOI: http://doi.org/10.5281/zenodo.20560823
