Perceptions regarding cardiovascular health and preparedness for digital health education among adolescents in an urban community of Nepal: A qualitative study

Background: Cardiovascular disease (CVD) is the leading cause of death in Nepal. As CVD risks can develop early in life, a life course approach for non-communicable disease (NCD) prevention is needed. Due to its potentially acceptable delivery mode, digital health education could be a promising way forward to increase adolescents' CVD knowledge. Purpose: The purpose of this study was to explore adolescents' CVD perceptions and their perceptions and preparedness for digital cardiovascular health education through mobile games. Methods: Twelve focus group discussions were conducted with adolescents, Grades 8-10, from two public and four private Nepalese schools. A qualitative study with a deductive thematic analysis was performed, guided by the health belief model (HBM) and the technology acceptance model (TAM). Results: The analysis resulted in 6 themes and 13 sub-themes concerning perceptions of CVD and 5 themes and 10 sub-themes on perceptions and preparedness for digital cardiovascular health education through mobile games. The adolescents viewed CVD as a serious disease with consequences. A healthy diet and physical activity were important for prevention. Benefits were the positive impacts of a heart-healthy lifestyle. Barriers were the temptation of consuming unhealthy food, lack of healthy food environments, time and motivation. The adolescents also stressed their own ability to prevent CVD. Digital cardiovascular health education through mobile games was desirable. Constraints were accessibility and technical issues, parental allowance, available time and whether the game was engrossing enough. Conclusion: The adolescents perceived CVD as serious, with benefits and barriers connected to its prevention. Digital cardiovascular health education through mobile games was viewed positively but not without constraints for successful implementation.