Perspectives on barriers and facilitators to lifestyle change after cardiac events amongst patients in Saudi Arabia: A qualitative study

Aims
Lifestyle interventions are an essential element in the prevention of cardiovascular disease. However, promoting healthy lifestyle is challenging because a multitude of factors interact and influence people’s decisions to adopt and maintain healthy lifestyles. The effects of these factors on Saudi cardiac patients are largely unknown. This study aimed to explore the barriers and facilitators to healthy lifestyle changes among Saudis after cardiac events.
Methods and results
The study followed an exploratory qualitative research design, using a social ecological approach. Semi-structured interviews were conducted with twenty-one participants (13 men and 8 women) patients who had a cardiac event. Participants were purposively recruited from cardiac clinics of two hospitals in Jeddah, Saudi Arabia. Data were analysed using the qualitative framework analysis and factors were identified as salient based on their frequency and the potential strength of their impact. Six factors were identified as influencing lifestyle behaviours in cardiac patients, categorised to “major” factors and “mediating” factors. The “major” factors were sociocultural norms; family values; and religious beliefs and the mediating factors were insufficient healthcare services, physical environment, and policy regulations. Depending upon the behaviours reported and the context, the same factor could be classified as both a barrier and a facilitator. 
Conclusion
The findings of this study can be used to inform the development of contextual-based interventions to promote the adoption of healthy lifestyles that meet the population needs and are relevant to the Saudi society.