Communication of Cardiovascular Disease Risk and Prevention Strategies at the Healthy Lifestyle Centres- reality vs expected quality: A cross-sectional mix-methods study

INTRODUCTION In the multiple-risk approach of cardiovascular disease management, communication of cardiovascular disease risk and its prevention play a significant role. in Sri Lanka, this function is conducted via Healthy Lifestyle Centres. METHODOLOGY A clinical audit was conducted to describe communication quality in 79 healthy lifestyle centers. A checklist developed based on Patient-Centered Communication Tools with the support of an expert panel. Two trained observers independently conducted the observations while the healthcare provider at the Healthy Lifestyle Centre revealed details of cardiovascular disease risk communication and health education sessions. RESULTS: The majority of Healthy Lifestyle Centers involved patients in decision-making (n = 228, 92.0%), explained patient choices (n = 230, 92.8%) and responded to patients' interest in decision-making (n =2 35, 99.2%). Most patients received a summary (n =159,67.1%), a follow-up plan (n =212,89.5%) and were communicated in a jargon-free language (n =127,53.6%). The majority of sessions demonstrated satisfactory use of examples (95.7%, n = 22), and responsiveness to questions (73.9%, n =17). However, most sessions were unsatisfactory regarding provision of a follow-up plan (95.7%, n = 22), encouragement of questions (95.7%, n = 22), allowing clients to talk (87.0%, n = 20), and active listening (69.6%, n = 16). CONCLUSIONS: Strengthening healthcare worker training in patient-centred communication especially shared decision-making, active listening, and encouraging patient questions are essential to improve cardiovascular disease risk communication and patient adherence to preventive guidelines at Healthy Lifestyle Centres. Key words Communication, Cardiovascular disease risk, health communication, effective communication, paternalistic healthcare