scholarly journals Can a nurse-led community-based model of hypertension care improve hypertension control in Ghana? Results from the ComHIP cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026799 ◽  
Author(s):  
Alma J Adler ◽  
Amos Laar ◽  
David Prieto-Merino ◽  
Reina M M Der ◽  
Debbie Mangortey ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Impact ◽  
Steering Committee ◽  
Eastern Region ◽  
Hypertension Control ◽  
Community Based ◽  
Improvement Project ◽  
High Loss ◽  
Referral Tool ◽  
The Impact

ObjectivesTo evaluate the effectiveness of the Community-based Hypertension Improvement Project (ComHIP) in increasing hypertension control.SettingLower Manya Krobo, Eastern Region, Ghana.ParticipantsAll adult hypertensive community members, except pregnant women, were eligible for inclusion in the study. We enrolled 1339 participants, 69% of whom were female. A total of 552 had a 6-month visit, and 338 had a 12-month visit.InterventionsWe report on a package of interventions where community-based cardiovascular disease (CVD) nurses were trained by FHI 360. CVD nurses confirmed diagnoses of known hypertensives and newly screened individuals. Participants were treated according to the clinical guidelines established through the project’s Technical Steering Committee. Patients received three types of reminder and adherence messages. We used CommCare, a cloud-based system, as a case management and referral tool.Primary outcomeHypertension control defined as blood pressure (BP) under 140/90 mm Hg. Secondary outcomes: changes in BP and knowledge of risk factors for hypertension.ResultsAfter 1 year of intervention, 72% (95% CI: 67% to 77%) of participants had their hypertension under control. Systolic BP was reduced by 12.2 mm Hg (95% CI: 14.4 to 10.1) and diastolic BP by 7.5 mm Hg (95% CI: 9.9 to 6.1). Due to low retention, we were unable to look at knowledge of risk factors. Factors associated with remaining in the programme for 12 months included education, older age, hypertension under control at enrolment and enrolment date. The majority of patients who remained in the programme were on treatment, with two-thirds taking at least two medications.ConclusionsPatients retained in ComHIP had increased BP control. However, high loss to follow-up limits potential public health impact of these types of programmes. To minimise the impact of externalities, programmes should include standard procedures and backup systems to maximise the possibility that patients stay in the programme.

scholarly journals The Impact of a Yearlong Diabetes Prevention Program-Based Lifestyle Intervention on Cardiovascular Health Metrics

2021 ◽  
Vol 12 ◽  
pp. 215013272110298
Author(s):  
Susan M. Devaraj ◽  
Bonny Rockette-Wagner ◽  
Rachel G. Miller ◽  
Vincent C. Arena ◽  
Jenna M. Napoleone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Lifestyle Intervention ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Cardiovascular Health ◽  
Diabetes Prevention Program ◽  
Behavioral Risk ◽  
Community Based ◽  
The Impact

Introduction The American Heart Association created “Life’s Simple Seven” metrics to estimate progress toward improving US cardiovascular health in a standardized manner. Given the widespread use of federally funded Diabetes Prevention Program (DPP)-based lifestyle interventions such as the Group Lifestyle Balance (DPP-GLB), evaluation of change in health metrics within such a program is of national interest. This study examined change in cardiovascular health metric scores during the course of a yearlong DPP-GLB intervention. Methods Data were combined from 2 similar randomized trials offering a community based DPP-GLB lifestyle intervention to overweight/obese individuals with prediabetes and/or metabolic syndrome. Pre/post lifestyle intervention participation changes in 5 of the 7 cardiovascular health metrics were examined at 6 and 12 months (BMI, blood pressure, total cholesterol, fasting plasma glucose, physical activity). Smoking was rare and diet was not measured. Results Among 305 participants with complete data (81.8% of 373 eligible adults), significant improvements were demonstrated in all 5 risk factors measured continuously at 6 and 12 months. There were significant positive shifts in the “ideal” and “total” metric scores at both time points. Also noted were beneficial shifts in the proportion of participants across categories for BMI, activity, and blood pressure. Conclusion AHA-metrics could have clinical utility in estimating an individual’s cardiovascular health status and in capturing improvement in cardiometabolic/behavioral risk factors resulting from participation in a community-based translation of the DPP lifestyle intervention.

scholarly journals 30.L. Workshop: European burden of disease network: strengthening the collaboration

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Risk Factors ◽  
Burden Of Disease ◽  
Health Impact ◽  
European Countries ◽  
Disease Assessment ◽  
Current Status ◽  
Cost Action ◽  
The Cost ◽  
The Impact ◽  
Technical Platform

Abstract The burden of disease (BoD) approach has become one of the foundations of descriptive epidemiology. Central to this approach is the use of the Disability-Adjusted Life Year as a comprehensive and comparable summary measure of population health. Driven by the impact of the Global Burden of Disease (BoD) study, several researchers and health institutes across the world have adopted the BoD approach to assess the health impact of diseases and risk factors, supporting a more rational allocation of available resources. Despite the increasing prominence of the BoD approach, several challenges remain. The BoD methodology is complex and highly data intensive, which has led to major disparities across researchers and nations in their capacity to perform BoD studies, to interpret the soundness of available BoD estimates, or to advocate for the use of BoD methods. Often, these disparities follow geographical boundaries–for instance, over half of all published BoD studies in Europe were set in the Netherlands, Spain and UK, while only 15% were set in eastern European countries. BoD as a generally standardized approach nonetheless requires different methodological choices, and lack of harmonization in these may hamper comparisons across studies. This is further aggravated by the fact that different BoD initiatives have remained scattered–there is for instance little interaction between infectious disease, nutritional and environmental epidemiologists, even though several methodological issues transcend the boundaries of diseases and risk factors. Finally, many BoD researchers are struggling to find optimal ways to translate their findings and communicate them adequately and comprehensively to decision makers and other stakeholders. In response to these needs, several countries and BoD researchers have set up ad hoc partnerships. In 2016, the WHO Regional Office for Europe (WHO-EURO) launched a European BoD network, aiming to intensify links between WHO, IHME and the WHO-EURO member states. In 2019, our group has launched a COST Action that aims to serve as a technical platform to integrate and strengthen capacity in BoD assessment across Europe and beyond. At the moment of writing, the “burden-eu” COST Action joins over 200 participants from 38 European countries, as well as several observers from non-European countries and international organizations. In this workshop, we give an overview of the current status and initial accomplishments of the COST Action, with a focus on the key challenges that the Action aims to address - i.e., increased interaction between existing efforts, methodological advances and technical capacity building at country level, and an actionable understanding of the process underlying knowledge translation. The different sessions will include interactions with the audience to learn about the needs and expectations of the attendees, and how these can be addressed by the COST Action. Key messages The burden of disease approach is increasingly used to generate comparable and comprehensive estimates of the health impact of diseases and risk factors. The 'burden-eu' COST Action offers a technical platform for integrating and strengthening capacity in burden of disease assessment across Europe and beyond.

scholarly journals Change in awareness levels of cervical cancer among rural women after intervention by health education: a community-based study

2020 ◽  
Vol 9 (3) ◽  
pp. 960
Author(s):  
G. Kalpana ◽  
Keshav Gangadharan ◽  
Pradeep S. ◽  
Devivaraprasad M.
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Health Education ◽  
Rural Women ◽  
Signs And Symptoms ◽  
Diagnosis And Treatment ◽  
Cluster Sampling ◽  
Community Based ◽  
Treatment And Prevention ◽  
The Impact

Background: Cervical cancer is the fourth most common cancer among women worldwide. The prevention and control of cervical cancer depends on awareness about the disease, screening procedures, and preventive measures. Objectives of this study was to assess the awareness levels on various aspects of cervical cancer among women aged 25-65 years, and to assess the impact of health education intervention among them.Methods: This community-based interventional study was conducted for a period of 15 months among 250 women aged 25-65 years by cluster sampling method in a rural population. Data on all aspects of awareness about cervical cancer, i.e., risk factors, signs and symptoms, diagnosis and treatment and prevention were collected using a pre-tested semi-structured proforma. This was followed by a post-test 2 months after health education.Results: Overall awareness for cervical cancer was found to be very poor among the study subjects in the pre-test. Awareness on risk factors, signs and symptoms, diagnosis and treatment, and prevention of cervical cancer was found to be 6%, 3.6%, 1.2%, and 1.6% respectively. A significant increase in the knowledge level was found after health education.Conclusions: As the awareness levels regarding the cervical cancer was poor among the study population, health education programme and campaigns, along with periodic screening is need of the hour to effectively prevent cervical cancer.

scholarly journals Development and evaluation of a package to improve hypertension control in Nigeria [DEPIHCON]: study protocol for a cluster randomized controlled trial

2021 ◽  
Author(s):  
IkeOluwapo Oyeneye Ajayi ◽  
Oyediran Emmanuel Oyewole ◽  
Okechukwu S Ogah ◽  
Joshua Odunayo Akinyemi ◽  
Mobolaji Modinat Salawu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Controlled Trial ◽  
Hypertension Control ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Community Based ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
And Control

Abstract Background: Nigeria’s healthcare system capacity to stem the increasing trend in hypertension is limited in coverage, scope and manpower. Use of trained community-based care providers demonstrated to be an effective complement in improving access to, and supporting healthcare delivery has not been adequately examined for hypertension care in Nigeria. This study is proposed to evaluate the effectiveness of using trained Community-based Oriented Resource Persons (CORPs) to improve hypertension control in Nigeria. Methods: An intervention study will be conducted in three states using mixed method design. First, is a baseline survey using a semi-structured pre-tested questionnaire to collect information on demographics, clinical data, knowledge, occurrence and risk factors of hypertension among 1,704 adults ≥18 years. Focus Group Discussions (FGD) and Key Informant Interviews (KII) will be conducted to explore community’s experience of hypertension, challenges with hypertension management, and support required to improve control in 10 selected communities in each state. The second is a cluster randomized controlled trial to evaluate effect of a package on reduction of blood pressure (BP) and prevention of cardiovascular (CVD) risk factors among 200 hypertensive patients to be followed up in intervention and control arms over a six-month period in each state. The package will include trained CORPs conducting community-based screening of BP and referral, diagnosis confirmation and initial treatment in the health facility, followed by monthly home-based follow-up care and provision of health education on hypertension control and healthy lifestyle enhanced by phone voice message reminders. In the control arm, the usual care (diagnosis, treatment and follow up care in hospital of patient’s choice) will continue. Third, an end-line survey will be conducted in both intervention and control communities to evaluate changes in mean BP, control, knowledge, and proportion of other CVD risk factors. In addition, FGD and KII will be used to assess participants’ perceived quality and acceptability of the interventions as delivered by CORPs.Discussion: This research is expected to create awareness, improve knowledge, perception, behaviours, attitude and practices that will reduce hypertension in Nigeria. Advocacy for buy-in and scale up of using CORPs in hypertension care by the government is key if found to be effective. Trial registration: PACTR Registry- PACTR202107530985857. Registered on 26 July 2021Url – https://pactr.samrc.ac.za

scholarly journals An Autopsy Study of Atherosclerotic Changes in Coronary Arteries at B.P. Koirala Institute of Health Sciences

2021 ◽  
Vol 1 (1) ◽  
pp. 4-8
Author(s):  
Sudhir Raman Parajuli ◽  
Bishwonath Yadav ◽  
Prahlad Karki ◽  
Paricha Upadhyaya ◽  
Shivendra Jha
Keyword(s):  
Risk Factors ◽  
Coronary Arteries ◽  
Heart Association ◽  
Conventional Technique ◽  
Histopathological Study ◽  
Eastern Region ◽  
Autopsy Study ◽  
Atherosclerotic Lesions ◽  
The Impact

Introduction: Atherosclerosis is a giant killer and the incidence of atherosclerosis in coronary arteries is rapidly increasing. The study was designed to assess the atherosclerotic lesions in coronary artery and to correlate the risk factors related to prevalence of atherosclerosis. Methods: Heart from 100 medico legal autopsy cases ranging between ages 15 to 35 years which came to BPKIHS Dharan were taken for this study and processed for coronary arteries using conventional technique. They were then studied,and grading was done based on Modified American Heart Association (AHA) classification of atherosclerosis. Results: Intimal thickening was noted in more than 90% in all three coronary arteries followed by intimal xanthoma whereas intermediate lesion for atherosclerosis was not found. Age, gender, smoking and alcohol in relation to atherosclerosis were found to be of no significance. Conclusion: The study highlights the impact of atherosclerotic lesions in the Eastern region of Nepal. Meticulous postmortem examination along with histopathological study is the best possible way to study atherosclerotic disease in humans and risk factors associated with it.

scholarly journals AN ANALYSIS ON KRI IMPROVEMENT PROJECT IN INDONESIAN NAVAL MAIN BASE NO. V SURABAYA FASHARKAN (NAVY’S BATTLESHIPS MAINTENANCE AND REPAIRING FACILITIES USING FUZZY FMEA METHOD

JOURNAL ASRO ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 77
Author(s):  
Eko Krisdiono ◽  
I Nengah Putra A ◽  
I Made Jiwa Astika ◽  
Bambang Suharjo
Keyword(s):  
Risk Factors ◽  
Failure Modes ◽  
Significant Risk ◽  
Repair Process ◽  
Eastern Region ◽  
Severity Factor ◽  
Effect Analysis ◽  
Improvement Project ◽  
Fuzzy Method ◽  
Fmea Method

The FMEA method is a tool used to identify the consequences or consequences of a system or process failure and reduce or eliminate failure. In determining risk factors and system improvement priorities, traditional FMEA still has weaknesses, where FMEA traditionally places severity factors, occurrence, and detection at the same level of importance, even though in reality different levels of importance and the importance of FMEA assessment teams are ignored.          In this study, the fuzzy method is integrated into FMEA where the severity factor, occurrence, and detection are assessed in linguistic form. In this fuzzy method, the weight of the interests of the FMEA assessment team is taken into account to do ranking and repair priorities. The application of Fuzzy methods to FMEA to determine significant risk factors and prioritizing improvements from various alternatives chosen for the process of repairing KRI in Surabaya Lantamal V, so that it is expected that the application of this method can improve the operational performance of Fasharkan to eliminate or reduce the risks that occur in the repair process ships in the eastern region of the fleet. Keywords: Risk Management, Failure Modes and Effect Analysis (FMEA), Fuzzy Method

Health Companion Project: A community-based participatory research model for health promotion in Iran

2017 ◽  
Vol 16 (2) ◽  
pp. 152-172
Author(s):  
Behrouz Yazdanpanah ◽  
Mitra Safari ◽  
Farahosadat Bahreini ◽  
Farzad Vafaei ◽  
Mohsen Salari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Participatory Research ◽  
Priority Setting ◽  
Community Based Participatory Research ◽  
Steering Committee ◽  
Local Health ◽  
Health Providers ◽  
Community Members ◽  
Community Based ◽  
Health Companion

A 4-year (2008–2011) community-based participatory research was implemented in the Kohgiloyeh and Boyerahmad province, Iran. A steering committee was established from academics, policy makers, health officials, and representatives of health sectors. This committee selected six regions within Boyerahmad and Dena counties based on administrative divisions. Health companions consisting of stakeholders, academics, local leaders, health providers, and public representatives were established to guide the project in each region. The health companion groups were enabled by attending workshops dealing with need assessment, priority setting, and research methodology. Health companion groups adopted a Planned Approach to Community Health (PATCH) methodology including community mobilization for data collection, health priority setting, developing of a comprehensive intervention plan, and evaluation. A list of main health issues and their priorities for each region was provided. Subsequently, research topics were determined and six surveys and intervention programs were planned and implemented. After intervention most of top priority health risk factors were decreased and the preventive programs that targeted risk factors were increased significantly. This project is found to be an effective approach for building stronger partnerships between researchers and community members for the development of effective solutions for local health concerns and promote public health.

A multidimensional measurement of the health impact of community-based water treatment systems in Uganda

2014 ◽  
Vol 5 (1) ◽  
pp. 1-8
Author(s):  
Jeffery L. Deal ◽  
Henry Massa ◽  
Kristen Check ◽  
Christiana Naaktgeboren ◽  
Alyson M. Malone ◽  
...  
Keyword(s):  
Water Treatment ◽  
Research Methods ◽  
Water Consumption ◽  
Healthcare Facility ◽  
Health Impact ◽  
The Other ◽  
Health Impacts ◽  
Unique Combination ◽  
Community Based ◽  
The Impact

Using a unique combination of ethnographic methods, healthcare facility chart reviews, and individual waterborne parasite tests, the health impacts of providing water treatment systems for communities in Uganda are compared to the impact measured using identical water technology and similar research methods in Honduras. While self-reported diarrhea rates improved in the Ugandan test communities when compared to controls, no significant impact was detected in any of the other measures. This contrasts sharply with findings in Honduras where all measures demonstrated statistically significant improvement after installation of identical water treatment systems. Ongoing ethnographic work reveals that knowledge of waterborne pathogens was universal in both Uganda and Honduras while practices related to water consumption varied greatly. Additional factors effecting these outcomes will be discussed.

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