Development, initial content validation and reliability of Nigerian Composite Lifestyle CVD risk factors questionnaire for adolescents

Background: Cardiovascular disease risk (CVD) factors affect every age category including adolescents in developing nations. Prevention strategies are effective only when there are epidemiological data for the targeted populations. The collection of such data is only made easy with composite lifestyle CVD risk factors measures that are culturally sensitive and acceptable among the target populations.Objective: The objective of the study was to develop a culturally sensitive and friendly composite lifestyle CVD risk factors questionnaire for adolescents in NigeriaMethods: A systematic review was conducted to identify existing, published questionnaires from which items could be selected. Content and face validation were conducted using an expert panel and a sub-sample of the target population. Data was analyzed qualitatively and reliability was assessed using intra-class correlation and Kappa statistic.Results: Based on the comments received from experts, the questions were restructured, simplified, clarified, formatted, some questions were added and expert reached a consensus. Kappa showed fair to moderate agreement in 65% of the questions and perfect agreement in one question.Conclusion: The CVD risk factors questionnaire has acceptable content validity and reliability and should be used to assess CVD risk factors among adolescents in NigeriaKey words: Cardiovascular disease, risk factors, questionnaire, adolescent

Management of LBP at primary care level in South Africa: up to standards?

Background: Primary Health Care (PHC) is well suited for management of low back pain (LBP). Prevalence of (chronic) LBP is suspected to be high among visitors of the South African primary care centers, but currently no information exists on prevalence or guideline adherence.Objectives: To establish if treatment received for LBP in public PHC in the Cape Town area compares with international evidence based guidelines.Methods: Cluster randomization determined the 8 community health centres where the study took place. A measurement tool was developed and validated for this population. Descriptive analysis and logistic regression analytical techniques were applied.Results: 489 participants (mean age: 44.8) were included in this study. Lifetime prevalence was 73.2% and 26.3% suffered from chronic low back pain (CLBP) . Pain medication was the only form of treatment received by 90% of the sample. Interventions received seemed to be unrelated to type of LBP (acute, sub acute and chronic). Referral to physiotherapy, education and advice to stay active were rarely done. Participants expressed low satisfaction with treatment.Conclusions: Current management of LBP at PHC level appears to be ineffective and not conform guidelines. Further South African research should focus on barriers as well as measures to be taken for implementation of LBP guidelines.Keywords: Low back pain, management, guidelines, primary care, South Afric