Evaluation of the Effectiveness of Nursing Interventions Aimed at Improving Cardiovascular Health Behaviors in Children

The school-age period is a phase where healthy behaviors can naturally be adopted and sustained throughout life. Unhealthy habits acquired during childhood are highly likely to lead to unhealthy adults (Arnaiz et al., 2021). Early age can be a key period for interventions, and the younger the intervention age, the more positive the outcomes. Therefore, a comprehensive healthy lifestyle intervention is needed in school settings as early as possible to reduce future cardiovascular disease risks (Dong et al., 2021). School-based initiatives are crucial in primary prevention programs for cardiovascular diseases (Yu et al., 2022). School-based programs for preventing cardiovascular diseases significantly contribute to the prevention of cardiovascular risk factors in children.Improving the content and practices of school-based cardiovascular disease prevention programs is essential to enhance their effectiveness. Integrating these programs into school curricula can significantly contribute to increasing their impact and widespread adoption (Amoah et al., 2021). It is necessary to promote ideal cardiovascular health in all children and improve the condition of those already experiencing cardiovascular health issues (Steinberger et al., 2016).

In a school-based study, interventions aimed at reducing cardiovascular risk factors were implemented, resulting in improvements in physical activity and fruit and vegetable consumption. Additionally, there was a decrease in the consumption of sugary foods and beverages as well as fried foods (Woodgate & Sigurdson, 2015). School-based cardiovascular health promotion initiatives contribute to increasing children's awareness of this issue. Strategies to foster a healthy lifestyle support cardiovascular health. Developing strategies to improve children's cardiovascular health is critical for reducing the burden of cardiovascular disease in the future (Woodgate & Sigurdson, 2015).

In a school-based obesity intervention study conducted in China, a reduction in the risk of overweight, obesity, and hypertension was observed in children aged 6-18 years. It was found that this reduction was greater in children aged 6-12 years compared to those aged 13-18 years (Dong et al., 2021).

According to the International Council of Nurses (2015), nurses, who represent the largest discipline in global healthcare, manage cardiovascular disease (CVD) risk factors and chronic diseases. The American Heart Association (AHA) and the World Health Organization (WHO) recognize the key role of nurses and other healthcare team members in supporting the goal of reducing CVD-related deaths and disabilities by 25% by 2025 (Smith et al., 2012; Yusuf et al., 2015). For over 40 years, nurses have played a crucial role in managing single and multiple risk factors through specialized clinics focused on hypertension, smoking, lipids, and diabetes, as well as through primary healthcare services, workplace programs, and cardiac rehabilitation initiatives (Miller & Froelicher, 2004; Fonarow et al., 2001).

Nurses have assumed a primary role as team leaders in providing case management, not only reducing CVD risk factors but also demonstrating their ability to adhere to treatment guidelines and protocols, reduce hospital admissions, and decrease morbidity and mortality in patients with heart disease (Berra et al., 2011; Berra, 2011; Allen et al., 2014). In the early 1990s, the SCRIP (Stanford Coronary Risk Intervention Project) study demonstrated that nurse-led risk reduction in patients with known CVD resulted in angiographically documented regression of the disease and a decrease in clinical events (Haskell et al., 1994). Following this landmark study, a series of clinical trials documented the significant and effective role of nurses in improving adherence to guideline-based medical treatments and lifestyle changes (Miller & Froelicher, 2004; Wood et al., 2008). The Cardiac Hospitalization Atherosclerosis Management Program showed a significant reduction in morbidity and mortality one year after discharge among patients who received nurse-led case management compared to those receiving usual care (Fonarow et al., 2001).The nursing profession plays a significant role in the prevention and control of cardiovascular diseases. School health nurses make substantial efforts to reduce the impact of cardiovascular diseases through responsibilities such as early diagnosis and intervention, education on healthy lifestyle changes, raising community awareness, monitoring risk factors, fostering family and community collaboration, and emergency management (Ministry of Health, 2015). It is essential for all nurses, particularly school health nurses, to have high levels of knowledge and awareness regarding cardiovascular diseases and their risk factors. Nurses should evaluate children they encounter in their work environments for cardiovascular disease risk factors, collect information from parents and children about these risk factors, and educate children and their families at high risk about the necessary precautions. Nurses should collaborate with schools to expand school-based cardiovascular health promotion initiatives and efforts to prevent cardiovascular disease risk factors (Hayman et al., 2015).