Cardiovascular disease risk perception and stages of preventive behaviours: a community survey in Pokhara Metropolitan, Nepal

Objectives Cardiovascular diseases (CVDs) are a leading cause of mortality in Nepal. Risk perception is crucial for the prevention of CVD-related behaviours. This study assessed CVD risk perceptions and the stages of preventive behaviours among adults in Pokhara Metropolitan, Nepal by integrating two theoretical models—the Health Belief Model and the Transtheoretical Model. Design This study used a cross-sectional design with data collected through a survey using a semistructured questionnaire. Setting This study was conducted from July 2024 to August 2024; among community people aged ≥20 residing in 11 wards of Pokhara Metropolitan. Participants A total of 384 community people residing in Pokhara Metropolitan, Nepal. Primary outcome and explanatory variables The primary outcome measure was stage of preventive behaviours of CVDs using Fuster BEWAT components (blood pressure, exercise, weight, diet and tobacco), while explanatory variables were sociodemographic characteristics and CVD Health Beliefs. Results A total of 384 adults participated (response rate=95%). The mean age was 42.3 years (SD±14.5), with equal representation of males and females. More than half of the participants (55.5%) perceived low susceptibility to CVDs, 40.4% perceived high severity, 78.4% perceived high benefits and 49.5% perceived moderate barriers. Most respondents were in the precontemplation stage for blood pressure control (43%) and weight management (30.5%), whereas maintenance was most common for physical activity (41.1%), healthy diet (51.3%) and smoking abstinence (80.1%). Ordinal logistic regression revealed that low perceived benefits significantly hindered behavioural progression (p=0.001–0.012), where low perceived barriers significantly facilitated advancement across all behaviours (p<0.05). The association for perceived susceptibility and severity was inconsistent. Overall, enhancing perceived benefits and reducing barriers were the strongest predictors of progression through stages of change in CBD preventive behaviours. Conclusions Perceived benefits and barriers were key predictors of progression in CVD prevention behaviours. While many adults maintained healthy diets, physical activity and smoking abstinence, most were in the early stage for blood pressure and weight control strategies. Strengthening perceived benefits and reducing barriers can enhance the adoption of healthy behaviours in Nepal.