Nursing Interventions for the Prevention and Management of Non-Communicable Diseases in Rural Areas: A Scoping Review
Abstract
Non-communicable diseases (NCDs) are the leading global health issue, with a steadily increasing prevalence and the highest mortality rates worldwide. Nurses play a crucial role within communities; evidence-based nursing interventions warrant further exploration. This study aimed to identify, classify, and synthesize nursing interventions and their outcomes in preventing and managing non-communicable diseases in rural communities. A scoping review was conducted of studies published between 2015 and 2025, using the PubMed, ProQuest, and EBSCOhost databases. A total of 4,170 records were identified and screened using relevant keywords and Boolean operators, and articles meeting the inclusion criteria were analysed using Rayyan AI. Fourteen studies were included in the final review. These studies were conducted in rural areas across 11 countries, including Australia, the USA, Portugal, Spain, China, Canada, Africa, Rwanda, Iran, the Netherlands, and Turkey. The research designs included four qualitative studies, one cohort study, two quasi-experimental studies, three Randomized Controlled Trials (RCTs), two descriptive studies, and one anthropological study. Both independent and collaborative nursing interventions have been shown to improve behaviour change, promote healthy lifestyles, and increase knowledge among patients and communities regarding NCDs. It is expected that the nursing profession and policymakers can implement these nursing interventions in populations living in rural or underserved areas with limited access to healthcare facilities.
References
Beluan, M. I. S., & Sukihananto. (2024). The Impact of Telehealth Implementation on Increasing Antenatal Care Visits: A Literature Review Dampak Penerapan Telehealth Terhadap Peningkatan Kunjungan Antenatal Care : A Literature Review. Lentera Perawat, 5(2).
Davis, S. M., Jones, A., Jaynes, M. E., Woodrum, K. N., Canaday, M., Allen, L., & Mallow, J. A. (2020). Designing a multifaceted telehealth intervention for a rural population using a model for developing complex interventions in nursing. BMC Nursing, 19(9), 1–9. https://doi.org/10.1186/s12912-020-0400-9
Florence, K. N. (2024). Community Nurse – Role and Responsibilities. Pulse Jobs. https://www.pulsejobs.com/news/community-nurse-role-and-responsibilities/
Frieden, M., Zamba, B., Mukumbi, N., Mafaune, P. T., Makumbe, B., Irungu, E., Moneti, V., Isaakidis, P., Garone, D., & Prasai, M. (2020). Setting up a nurse-led model of care for management of hypertension and diabetes mellitus in a high HIV prevalence context in rural Zimbabwe: a descriptive study. BMC Health Services Research, 20(1), 486. https://doi.org/10.1186/S12913-020-05351-X
Gagnon, D. (2024). Telehealth in Nursing . Southern New Hampshire. https://www.snhu.edu/about-us/newsroom/health/role-of-telehealth-in-nursing
Gomes, L., Liébana-Presa, C., Araújo, B., Marques, F., & Fernández-Martínez, E. (2021). Heart disease, now what? Improving quality of life through education. International Journal of Environmental Research and Public Health, 18(6), 1–10. https://doi.org/10.3390/ijerph18063077
Harris, M. F., Tran, A., Porwal, M., Aslani, P., Cullen, J., Brown, A., Harris, E., Harris-Roxas, B., Doolan-Noble, F., Javanparast, S., Wright, M., Osborne, R., & Osten, R. (2024). Codesigning a Community Health Navigator program to assist patients to transition from hospital to community. Australian Journal of Primary Health, 30(5), 1–10. https://doi.org/10.1071/PY24042
Hasyim, M. (2024). Tantangan dan Peluang Pendidikan Kesehatan di Era Digital: Membangun Kesadaran Kesehatan Online. Oshada, 1(2), 16–24. https://doi.org/10.62872/4KD2XY97
Hopkins, S., Bacon, R., & Flynn, A. (2022). Student outcomes for interprofessional education in student led clinics: A rapid review. Journal of Interprofessional Care, 36(2), 234–244. https://doi.org/10.1080/13561820.2020.1858767
Housden, L., Browne, A. J., Wong, S. T., & Dawes, M. (2017). Attending to power differentials: How NP-led group medical visits can influence the management of chronic conditions. Health Expectations, 20(5), 862–870. https://doi.org/10.1111/HEX.12525
Hu, W., Li, T., Cao, S., Gu, Y., & Chen, L. (2022). Influence of Nurse-Led Health Education on Self-Management Ability, Satisfaction, and Compliance of Elderly Patients with Chronic Obstructive Pulmonary Disease Based on Knowledge, Belief, and Practice Model. Computational & Mathematical Methods in Medicine, 2022, 1–9. https://doi.org/10.1155/2022/1782955
Hulme, A., Sangelaji, B., Walker, C., Fallon, T., Denham, J., Martin, P., Woodruffe, S., Bell, K., Aniftos, M., Kirkpatrick, J., Cotter, N., Osborn, D., & Argus, G. (2024). Efficacy of a student-led interprofessional health clinic in regional Australia for preventing and managing chronic disease. Journal of Interprofessional Care, 38(5), 893–906. https://doi.org/10.1080/13561820.2024.2380436
Jefferies, J. G., Bishop, S., & Hibbert, S. (2021). Service innovation through resource integration: An empirical examination of co-created value using telehealth services. Public Policy and Administration, 36(1), 69–88. https://doi.org/10.1177/0952076718822715
Kurt, D., & Gurdogan, E. P. (2022). The effect of self-management support on knowledge level, treatment compliance and self-care management in patients with hypertension. Australian Journal of Advanced Nursing, 39(3), 14–23. https://doi.org/10.37464/2020.393.543
Menteri Kesehatan. (2019). Katalog Data - Layanan Permintaan Data | Kementerian Kesehatan RI. Riset Kesehatan Daerah. https://layanandata.kemkes.go.id/katalog-data/riskesdas/ketersediaan-data/riskesdas-2018
Menteri Kesehatan. (2023). Survei Kesehatan Indonesia (SKI) 2023. Badan Kebijakan Pembangunan Kesehatan. https://www.badankebijakan.kemkes.go.id/hasil-ski-2023/
Mistry, S. K., Harris, E., & Harris, M. (2021). Community Health Workers as Healthcare Navigators in Primary Care Chronic Disease Management: a Systematic Review. Journal of General Internal Medicine, 36(9), 2755. https://doi.org/10.1007/S11606-021-06667-Y
Mohebi, Z., Bijani, M., Alkamel, A., Dehghan, A., & Karimi, S. (2025). The impact of an educational discharge program based on Orem’s self-care model on lifestyle, hope, and treatment adherence in coronary angioplasty patients: a randomized controlled clinical trial. BMC Research Notes, 18(1), 1–9. https://doi.org/10.1186/S13104-025-07164-9
Mourad, O., Hossam, H., Zbys, F., & Ahmed, E. (2016). Rayyan: a Web and Mobile App for Systematic Reviews. Rayyan. https://doi.org/10.1186/s13643-016-0384-4
Munn, Z., Pollock, D., Khalil, H., Alexander, L., McLnerney, P., Godfrey, C. M., Peters, M., & Tricco, A. C. (2022). What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis. JBI Evidence Synthesis, 20(4), 950–952. https://doi.org/10.11124/JBIES-21-00483
Ndayisaba, A., Harerimana, E., Borg, R., Miller, A. C., Kirk, C. M., Hann, K., Hirschhorn, L. R., Manzi, A., Ngoga, G., Dusabeyezu, S., Mutumbira, C., Mpunga, T., Ngamije, P., Nkikabahizi, F., Mubiligi, J., Niyonsenga, S. P., Bavuma, C., & Park, P. H. (2017). A Clinical Mentorship and Quality Improvement Program to Support Health Center Nurses Manage Type 2 Diabetes in Rural Rwanda. Journal of Diabetes Research, 2017, 1–10. https://doi.org/10.1155/2017/2657820
Pandie, J. I., & Handayani, D. (2023). Literature Review: Pelaksanaan Program Pencegahan dan Pengendalian Penyakit Tidak Menular di Provinsi Jawa Timur. Jenggala, 2(2), 8–13.
Pérez-Rivas, F. J., Rico-Blázquez, M., López-López, C., Domínguez-Fernández, S., Cobos-Serrano, J. L., & Ajejas Bazán, M. J. (2023). “Learning by doing”, a model for improving the promotion of healthy lifestyles by student nurses. BMC Nursing, 22(1), 1–8. https://doi.org/10.1186/s12912-023-01398-3
Rachmawati, S., Prihhastuti-Puspitasari, H., & Zairina, E. (2019). The implementation of a chronic disease management program (Prolanis) in Indonesia: a literature review. Journal of Basic and Clinical Physiology and Pharmacology, 30(6). https://doi.org/10.1515/JBCPP-2019-0350
Sari, D. S. K., Lipoeto, N. I., Bachtiar, H., Catri, I., Sari, N. K., & Semiarty, R. (2024). Assessing Telemedicine Demand and Viability in Indonesian Geriatric Clinics: A Comprehensive HOT FIT and Sociotechnical Analysis. Current Aging Science, 18(1), 47. https://doi.org/10.2174/0118746098302999240522092726
Smith, C., McNaughton, D. A., & Meyer, S. (2016). Client perceptions of group education in the management of type 2 diabetes mellitus in South Australia. Australian Journal of Primary Health, 22(4), 360–367. https://doi.org/10.1071/PY15008
Su, L., Lv, X., Yang, X., Wang, X., Qu, L., & Zhang, C. (2025). Facilitating and Hindering Factors of Health Help-Seeking Behavior in Patients with Chronic Diseases: A Qualitative Study. Healthcare, 13(2164), 1–17. https://doi.org/10.3390/healthcare13172164
Tricco, A., Lilie, E., Zarin, W., O’brien, K., Colquhoun, H., Levac, D., Moher, D., Peters, M., Horsley, T., Weeks, L., & Hempel, S. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Westland, H., Koop, Y., Schröder, C. D., Schuurmans, M. J., Slabbers, P., Trappenburg, J. C. A., & Vervoort, S. C. J. M. (2018). Nurses’ perceptions towards the delivery and feasibility of a behaviour change intervention to enhance physical activity in patients at risk for cardiovascular disease in primary care: a qualitative study. BMC Family Practice, 19(1), 194. https://doi.org/10.1186/S12875-018-0888-1
WHO. (2019). World health statistics 2019: monitoring health for the SDGs, sustainable development goals. World Health Organization. https://www.who.int/publications/i/item/9789241565707
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