scholarly journals Motivators and Deterrents to Diet Change in Low Socio-Economic Pakistani Patients With Cardiovascular Disease

2019 ◽  
Vol 6 ◽  
pp. 233339361988360
Author(s):  
Rubina Barolia ◽  
Pamela Petrucka ◽  
Gina Awoko Higginbottom ◽  
Faris Farooq Saeed Khan ◽  
Alexander M. Clark

This study explores factors that affect the people of low socioeconomic status regarding food choices after diagnosis with cardiovascular disease. Qualitative approach was used to identify the important factors associated with dietary changes as a result of their disease. Twenty-four participants were interviewed from two cardiac facilities in Karachi, the largest metropolitan city of Pakistan. Data were analyzed to identify the themes using the interpretative description approach. While most participants understood the need for dietary changes, few were able to follow recommended diets. Their food choices were primarily influenced by financial constraints as well as cultural, familial, and religious values and practices. The challenge for health care providers lies in understanding the economical, sociocultural, and religious factors that influence behavioral changes which, in turn, affect dietary choices. It is apparent that cardiovascular risk and disease outcomes for the people of low socioeconomic status are likely to escalate. Thus, it is necessary to address the sociocultural, religious, and behavioral factors affecting dietary choices. Achieving this imperative requires an intersectorial, multilevel intervention for the prevention of cardiovascular diseases in people of low socioeconomic status.

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lisa Van Wilder ◽  
Peter Pype ◽  
Fien Mertens ◽  
Elke Rammant ◽  
Els Clays ◽  
...  

Abstract Background Little is known about how patients with low socioeconomic status (SES) experience their chronic disease, and how it impacts health-related quality of life (HRQoL). Compared to their more affluent counterparts, worse outcomes have been reported. A better understanding of the domains of HRQoL that are relevant to these specific populations is therefore needed. We explored the experiences of living with a chronic disease in low SES persons. Methods A qualitative interview study was performed in Flanders, Belgium. Semi-structured interviews were conducted in chronically ill patients, selected through purposive sampling. Interviews were audio-recorded and transcribed verbatim. Analysis followed an inductive and iterative approach. Results Fifteen patients were interviewed. Six major themes were identified: a heavy bag to carry, loss of autonomous life, inner and outer loneliness, emotional imbalance, unmet need for support, and coping strategies. Patients experienced their illness as an additional problem on top of all other problems (i.e. financial/social problems, traumatic life events). In general, the disease burden and non-disease burden were mutually reinforcing, resulting in greater dependency, greater risk of social isolation, greater psychological distress, and greater risk of impaired HRQoL. Conclusions This study is the first to provide detailed insight into the experiences of living with a chronic disease in low SES persons. A conceptual model is proposed that can be used in daily clinical practice to raise awareness among clinicians and health care providers that the patient’s needs go beyond the disease itself. Future research is needed to validate and test the model.


2016 ◽  
Vol 28 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Alexandra A. García ◽  
Julie A. Zuñiga ◽  
Czarina Lagon

People from non-White racial groups and other underserved populations, including Latinos, are frequently reluctant to participate in research. Yet their participation into research is foundational to producing information that researchers and health care providers need to address health disparities. The purpose of this article is to describe challenges we have encountered along with culturally relevant strategies we used in five research studies to recruit Mexican American participants from community settings, some of whom were also of low socioeconomic status. We found that the most effective recruitment strategies reflect the common cultural values of personalismo, simpátia, confianza, respeto, and familismo.


2021 ◽  
Author(s):  
◽  
Jade Leavitt

Type 2 diabetes mellitus (T2DM) is an increasing concern in Canada, with low socioeconomic status being a major risk factor. This review explores strategies to improve food access that promote healthy food choices among people experiencing food insecurity and living with T2DM. Whittemore and Knalf’s (2015) integrative literature review methodology was used to extract and analyse the evidence. Four key strategies emerged: 1) promoting healthy food affordability through incentives and disincentives, 2) understanding effective and ineffective food interventions, 3) enhancing nutritional education in the standard of care, and 4) manifesting empowerment through self-efficacy and diabetes management. These strategies can be applied by nurse practitioners within primary care. Aligned with a population health approach, they can direct practice, education, and research through healthy public policy focused on reducing the incidence of T2DM, particularly in people experiencing food insecurity.


Stroke ◽  
2014 ◽  
Vol 45 (4) ◽  
pp. 954-960 ◽  
Author(s):  
Rebecca C. Thurston ◽  
Samar R. El Khoudary ◽  
Carol A. Derby ◽  
Emma Barinas-Mitchell ◽  
Tené T. Lewis ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Jaime Galindo-Quintero ◽  
Hector Fabio Mueses-Marin ◽  
David Montaño-Agudelo ◽  
María Virginia Pinzón-Fernández ◽  
Inés Constanza Tello-Bolívar ◽  
...  

HIV testing rates remain very low in Colombia, with only 20% of individuals at risk ever tested. In order to tackle this issue, the Corporacion de Lucha Contra el Sida (CLS) has implemented a multidisciplinary, provider-initiated, population-based HIV testing/counselling strategy named BAFI. In this report, we describe the experience of CLS at reaching populations from low socioeconomic backgrounds in 2008-2009. Two different approaches were used: one led by CLS and local health care providers (BAFI-1) and the other by CLS and community leaders (BAFI-2). Both approaches included the following: consented HIV screening test, a demographic questionnaire, self-reported HIV knowledge and behaviour questionnaires, pre- and posttest counselling, confirmatory HIV tests, clinical follow-up, access to comprehensive care and antiretroviral treatment. A total of 2085 individuals were enrolled in BAFI-1 and 363 in BAFI-2. The effectiveness indicators for BAFI-1 and BAFI-2, respectively, were HIV positive-confirmed prevalence = 0.29% and 3.86%, return rate for confirmatory results = 62.5% and 93.7%, return rate for comprehensive care = 83.3% and 92.8%, and ART initiation rate = 20% and 76.9%. Although more people were reached with BAFI-1, the community-led BAFI-2 was more effective at reaching individuals with a higher prevalence of behavioural risk factors for HIV infection.


2021 ◽  
pp. OP.20.01053
Author(s):  
Atul Batra ◽  
Shiying Kong ◽  
Winson Y. Cheung

PURPOSE: Patients with cancer are predisposed to develop new-onset cardiovascular disease (CVD). We aimed to assess if rural residence and low socioeconomic status modify such a risk. METHODS: Patients diagnosed with solid organ cancers without any baseline CVD and on a follow-up of at least 1 year in a large Canadian province from 2004 to 2017 were identified using the population-based registry. We performed logistic regression analyses to examine the associations of rural residence and low socioeconomic status with the development of CVD. RESULTS: We identified 81,418 patients eligible for the analysis. The median age was 62 years, and 54.3% were women. At a median follow-up of 68 months, 29.4% were diagnosed with new CVD. The median time from cancer diagnosis to CVD diagnosis was 29 months. Rural patients (32.3% v 28.5%; P < .001) and those with low income (30.4% v 25.9%; P < .001) or low educational attainment (30.7% v 27.6%; P < .001) experienced higher rates of CVD. After adjusting for baseline factors and treatment, rural residence (odds ratio [OR], 1.07; 95% CI, 1.04 to 1.11; P < .001), low income (OR, 1.17; 95% CI, 1.12 to 1.21; P < .001), and low education (OR, 1.08; 95% CI, 1.04 to 1.11; P < .001) continued to be associated with higher odds of CVD. A multivariate Cox regression model showed that patients with low socioeconomic status were more likely to die, but patients residing rurally were not. CONCLUSION: Despite universal health care, marginalized populations experience different CVD risk profiles that should be considered when operationalizing lifestyle modification strategies and cardiac surveillance programs for the growing number of cancer survivors.


2019 ◽  
Vol 26 (16) ◽  
pp. 1762-1770 ◽  
Author(s):  
Keren L Greenberg ◽  
Elisheva Leiter ◽  
Milka Donchin ◽  
Nisreen Agbaria ◽  
Mayada Karjawally ◽  
...  

Background For many women in low socioeconomic status communities, limited health literacy is an obstacle to following medical guidance and engaging in health-promoting behaviours. Low health literacy skills are also associated with an increased risk of cardiovascular disease. Design A health literacy intervention was designed through focus groups with women in low socioeconomic status communities. The primary health literacy issue identified was communication challenges at doctors’ visits. A unique intervention tailored to the participants’ preferences was designed consisting of three workshops conducted in community women’s groups in low socioeconomic status Jerusalem communities. The intervention aimed to increase patient–physician communication skills through doctor visit preparation and better visit management, improve perceived efficacy in patient–physician interaction and expand cardiovascular disease knowledge. Methods Questionnaires were completed before and 3 months after the intervention, assessing knowledge of cardiovascular disease risk factors and symptoms, self-report of behaviours in preparations for a doctor’s visit, and perceived efficacy in patient–physician interaction. Results A total of 407 women from low socioeconomic status communities completed questionnaires. Post-intervention, the percentage of women that reported preparing for doctors’ visits increased significantly. Women with initially low levels of perceived efficacy in patient–physician interaction showed a significant increase in perceived efficacy, while initially higher perceived efficacy in patient–physician interaction participants showed a decrease. Participants also demonstrated an increase in knowledge of several risk factors for cardiovascular disease and heart attack symptoms. Conclusions A community-based cardiovascular health literacy intervention improved cardiovascular knowledge and reported doctor visit preparation in low socioeconomic status women as well as increased perceived efficacy in patient–physician interaction among participants with low baseline perceived efficacy in patient–physician interaction. This may lead to improved health care utilisation, preventing chronic illness. Registered at ClinicalTrials.gov, https://www.clinicaltrials.gov , registration number: NCT03203018


Sign in / Sign up

Export Citation Format

Share Document