Effectiveness of Community-Based Stroke Risk Reduction Programs for Older Adults with Chronic Non-Communicable Diseases: An Integrative Review

Abstract

Stroke is a severe global public health problem, particularly among older adults with non-communicable diseases (NCDs) who represent a major risk group. Risk reduction and disease management at the community level are therefore essential for primary prevention. This study aimed to review and synthesize empirical evidence regarding the effectiveness of stroke risk reduction programs among older adults with NCDs in the community. An integrative review was conducted based on the framework of Whittemore and Knafl. Research articles published between 2014 and 2024 were systematically searched from PubMed/MEDLINE, CINAHL, and ThaiJO databases using the PICOS framework and following the PRISMA Flow 2020 guidelines.

From an initial search of 17,869 articles, 25 studies met the inclusion criteria for analysis. The results revealed that most programs focused on health behavior modification and the utilization of health technology, applying the concepts of self-efficacy, empowerment, and self-management. These programs were primarily implemented by registered nurses and public health personnel. The findings demonstrated that the programs effectively reduced risk factors, enhanced knowledge, improved health behaviors, and resulted in better clinical outcomes among older adults. In conclusion, community-based stroke risk reduction programs are highly effective in mitigating key risk factors, especially those that integrate self-management with health technology for continuous monitoring. These findings support primary care settings and nurses in adopting such models for proactive stroke prevention in the community.