Community perspectives on cardiovascular disease and risk on Carriacou: A rapid assessment procedure

The Grenada Heart Project intends to reduce cardiovascular risk factors in the country of Grenada through epidemiologic research and public health interventions. Both can benefit from incorporation of formative qualitative research methods. However, these are often time consuming and difficult to use. We proposed that using rapid assessment procedures that employ expedited qualitative methods would both engage the community and provide guidance to the research and intervention design. Our multidisciplinary, mixed gendered, mixed age research team included both US and local members. Using a semi-structured, systematic method, we investigated local knowledge, beliefs, and attitudes on key health domains (health/heart health; weight/stress/migration; risk behaviors) using participant observation (3 days) and 25 semi-interviews (health, government, business leaders, residents). Our analyses employed iterative processes, identified key survey design, and made deployment recommendations. Using these results, we revised the World Health Organization's STEP-wise surveillance system for chronic disease questionnaire to include questions regarding fish intake, other local foods of cardiovascular interest, gardening practices, “bush” or herbal treatments, the recreational use of marijuana, as well as issues regarding migration and emotional stress. Due to local concerns that we discovered through our work, plans for phlebotomy were changed to a finger-stick method of blood analysis. We conclude that data from a set of qualitative data-gathering tools were invaluable in the design of an epidemiologic study in Grenada, the West Indies. This rich set of information also assisted the project team's understanding of the environmental and social aspects of cardiovascular health in this Caribbean nation.