scholarly journals Evaluation of an evidence-based educational intervention aiming to integrate treatment of tobacco dependence into daily clinical practice in primary health care in Crete

2018 ◽  
Author(s):  
Χάρις Γιρβαλάκη
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Intervention Group ◽  
Training Intervention ◽  
Control Group ◽  
Evidence Based ◽  
Cross Sectional ◽  
Primary Health ◽  
Tobacco Treatment ◽  
And Control

Aim: This doctoral dissertation aimed to evaluate the efficacy of a tobacco treatment training intervention among General Practitioners (GPs) working in primary health care in Crete, Greece. The study objectives were: (a) to determine whether the tobacco treatment training intervention when delivered among GPs can increase GPs’ knowledge, attitudes, beliefs, perceived behavioral control, and intentions related to the delivery of tobacco treatment, and (b) whether the tobacco treatment training intervention when delivered among GPs can change GPs’ behaviors related to the delivery of tobacco treatment interventions (4As delivery). Study population & methods: A quasi-experimental pilot study with pre-post evaluation was conducted in Crete, Greece (2015-2016). GPs (n = 24) intervention and control group and a cross-sectional sample of their patients (n = 841) were surveyed before the implementation of the intervention. GPs in the intervention group received training, practice, and patient tools to support the integration of the 4As treatment into clinical routines. Intervention group GPs (n = 14) and a second cross-sectional sample of patients (n = 460) were surveyed 4 months following the intervention to assess changes in outcomes of interest. Multilevel modeling was used to analyze data.Results: Among GPs exposed to the intervention, significant increases in 6 of the 13 domains of knowledge, self-efficacy (14.3% vs. 64.3%; p=0.034) and rates of 4As delivery were documented between the pre-and post-assessment and compared to the control group. Specifically, the adjusted odds ratios (AOR) and 95% confidence intervals (CI) for 4As delivery between the intervention and control groups were: AOR ‘ask’ 3.66 (95%CI 2.61, 5.14; p<0.001); AOR ‘advice’ 4.44 (95%CI 3.18, 6.21; p<0.001); AOR ‘assist’ 13.71 (95%CI 9.30, 20.19; p<0.001) and AOR ‘arrange’ 4.75 (95%CI 2.67, 8.45; p<0.001).Conclusions: This is the first study to evaluate a multi-component tobacco treatment intervention in primary health care in Crete, Greece. The study findings demonstrate that the tobacco treatment training intervention in primary care settings was associated with significant improvements in the rates at which GPs deliver evidence-based tobacco treatment into their daily clinical practice. Future research should examine methods for supporting broader dissemination of well-designed training interventions in general practice in Greece and other European countries.

scholarly journals The Influence of Aloe Vera Juice on Lipid Profile at Prediabetes Patient in East Pontianak Primary Health Care Center, Indonesia

2020 ◽  
Vol 11 (3) ◽  
pp. 4603-4607
Author(s):  
Muhammad Faisal ◽  
Rahayu Indriasari ◽  
Meta Mahendradatta ◽  
Rukman Abdullah ◽  
Masrianih ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Triglyceride Level ◽  
Care Center ◽  
Intervention Group ◽  
Control Group ◽  
Health Care Center ◽  
Primary Health ◽  
Significant Difference ◽  
And Control

Aloe is a medicinal plant in Indonesia, which is often used as traditional medicine. The purpose of this study was to find out the influence of Aloe juice administration on changes in lipid profile (HDL, LDL, Triglycerides) in East Pontianak Primary Health Care Center. This study used quasi-experimental. This study used sampling on 36 people in 2 groups. In the treatment group, there was Aloe juice administration of 250 ml/day for 15 days while in the control group there was no Aloe juice administration. HDL level in the intervention group had an increase of 14.89 mg/ whereas in the control group had an increase of 1.22 mg/, where there was no significant difference between the intervention group and control group (p&gt; 0.05), LDL level in the intervention group had a decrease of 10.56 mg/ while the control group had a decrease of 5.94 mg/ where there was no significant difference between the intervention group and the control group (p&gt; 0.05) and triglyceride level in the intervention group had a decrease of 8.78 mg/ whereas in the control group had a decrease of 3.50 mg/ where there was no significant difference between the intervention group and the control group (p&gt; 0.05) which means intervention group and control group had no significant differences. The mean HDL level had an increase while the LDL level and triglyceride level had a decrease.

Manajemen Diri (Self Management) Perilaku Sehat pada Pasien Hipertensi

2021 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Vera Kurnia ◽  
Desti Nataria
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Intervention Group ◽  
Sampling Technique ◽  
Healthy Diet ◽  
Rank Test ◽  
Control Group ◽  
Healthy Behavior ◽  
Education Management ◽  
Primary Health

Hypertension is one of the most common causes of morbidity and mortality  all over the world, also known as “the silent killer” because people with hypertension are without symptoms. West Sumatera Province reported that the prevalence of hypertension at the age 18 years has increased from 25,8% in 2013 to 31,7% in 2018. Successful strategies to manage the blood preasure depends on patients self-care management or the ability and willingness of the patient to change and maintain certain behavior.The purpose of this research is to determine the effect of self-education management of hypertension patients in the working area of primary health care in Bukittinggi.Design of this research is a quasi experimental design with pretest-posttest with control group. The sample which used were 62 respondents consist of 31 people in the intervention group and 31 people in the group control. Sampling was done by consecutive sampling technique. Data was analyzed Wilcoxon signed rank test and Mann Whitney test. The result of this research shows that there isn’t any effect of self education management to healthy behavior which includes exercise and healthy diet of the intervention group and the control group at community health center in Bukittinggi (mean rank after the intervention < 10; p> 0,05). Based on the result of this research it can be concluded that the habits of respondents who carry out light and medium activities every day and also education provided by primary health care  have given big impact to respondent’s habits where they always do exercise and healthy diet in their daily life.The result of this research can be used as an input for primary health care to maintain and improve education of healthy behavior for hypertension patients.

scholarly journals Knowledge, adherence and control among patients with hypertension attending a peri-urban primary health care clinic, KwaZulu-Natal

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Olumuyiwa A. Olowe ◽  
Andrew J. Ross
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cross Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Care Clinic ◽  
Primary Health ◽  
Validated Questionnaire ◽  
Study Population ◽  
And Control

Background: Despite hypertension being a common condition among patients attending primary health care (PHC) clinics, blood pressure (BP) control is often poor. Greater insight into patient-related factors that influence the control of hypertension will assist in the development of an intervention to address the issues identified.Aim: The aim of the study was to assess patient-related variables associated with hypertension control among patients attending a peri-urban PHC clinic.Setting: The setting for this study was a peri-urban PHC clinic in KwaZulu-Natal.Method: This was an observational, descriptive and cross-sectional study with 348 patients selected over a 1-month period. A validated questionnaire was used to collect data on patients’ hypertension knowledge and self-reported adherence, and BP recordings from their medical record were recorded to ascertain control.Results: Of the 348 participants, only 49% had good BP control and 44% (152/348) had concurrent diabetes mellitus. The majority of patients had moderate levels of knowledge on hypertension and exhibited moderate adherence. There was a significant relationship between knowledge and reported adherence, between reported adherence and control, but not between reported knowledge and control.Conclusion: Despite over 90% of the study population having moderate knowledge, and 62% with moderate reported adherence, BP was well controlled in only less than 50% of the study population. These findings suggest a need to emphasise adherence and explore new ways of approaching adherence.

scholarly journals Effect of implementation intention on walking in people with diabetes

2020 ◽  
Vol 54 ◽  
pp. 103
Author(s):  
Marco Antonio Vieira da Silva ◽  
Thaís Moreira São-João ◽  
Marilia Estevam Cornelio ◽  
Fábio Luiz Mialhe
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Leisure Time Physical Activity ◽  
Intervention Strategy ◽  
Intervention Group ◽  
Implementation Intention ◽  
Control Group ◽  
Primary Health ◽  
Significant Difference

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

The effect of pillbox use and education by pharmacist toward medication adherence in diabetes mellitus patients in a Primary Health Care Center in Mataram

2021 ◽  
Vol 32 (4) ◽  
pp. 577-582
Author(s):  
Mahacita Andanalusia ◽  
Yunita Nita ◽  
Umi Athiyah
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Primary Health Care ◽  
Medication Adherence ◽  
Care Center ◽  
Intervention Group ◽  
Primary Health Care Center ◽  
Control Group ◽  
Health Care Center ◽  
Primary Health

Abstract Objectives Nonadherence to a long-term therapy, including diabetes mellitus, is one of the global problems that need to be overcome. This study aims to determine the effect of pillbox use and education by pharmacists toward medication adherence in patients with diabetes mellitus in a Primary Health Care Center in Mataram. Methods This research was an experimental research design with pretest-posttest with control group design. The study was conducted from October to December 2019 at Tanjung Karang Primary Health Care Center, Mataram. Measurement of adherence was done using the Adherence to Refill and Medication Scale questionnaire. The higher the score, the more nonadherence the patients. Patients were divided into three groups, which were the control group, educational intervention group, and pillbox and educational intervention group. Each group consisted of 11 patients. Results Patients’ medication adherence increased from 19.54 (SD 4.37) to 15.18 (SD 2.64) in the education and pillbox intervention group (p=0.004). Whereas, in the education and control group, the adherence did not provide a significant change (p>0.05). Based on the difference in adherence scores, it was known that what contributed to changes in compliance was refilling medicine and intentional nonadherence in taking medicine subscale (p=0.024). Conclusions Providing education and pillbox done by pharmacists at the Primary Health Care Center can increase adherence to the therapy of diabetes mellitus patients. Pharmacists at the Primary Health Care Center can use the intervention model to improve the level of adherence of patients with chronic illness.

scholarly journals Does a brief work-stress intervention prevent sick-leave during the following 24 months? A randomized controlled trial in Swedish primary care

Work ◽  
2021 ◽  
pp. 1-10
Author(s):  
Jenny Hultqvist ◽  
Pernilla Bjerkeli ◽  
Gunnel Hensing ◽  
Kristina Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sick Leave ◽  
Early Identification ◽  
Controlled Trial ◽  
Intervention Group ◽  
Training Session ◽  
Control Group ◽  
Treatment As Usual ◽  
Primary Health

BACKGROUND: Work-related stress (WRS) presents a risk for sick leave. However, effective methods to identify people at risk for sick leave due to WRS at an early stage are lacking in primary health care. OBJECTIVE: To evaluate whether a systematic early identification of WRS can prevent sick leave over 24 months after the intervention. METHODS: Study participants (n = 132 intervention; n = 139 control) were employed, non-sick-listed persons seeking care at primary health care centres. The intervention included early identification of WRS by a validated instrument, general practitioner (GP) awareness supported by a brief training session, patients’ self-reflection by instrument completion, GP giving the patient feedback at consultation and GP identifying preventive measures. The control group received treatment as usual. Outcome data were retrieved from the Swedish Social Insurance Agency. RESULTS: The intervention group had less registered median sick leave days (n = 56) than the control group (n = 65) but the difference was not statistically significant. CONCLUSIONS: The brief intervention was not proven effective in preventing sick leave in the following 24 months compared to treatment as usual. Further research on how to identify, advice and treat those at high risk for sick leave in primary health care is needed.

scholarly journals Multiple micronutrients in powder delivered through primary health care reduce iron and vitamin A deficiencies in young Amazonian children

2016 ◽  
Vol 19 (16) ◽  
pp. 3039-3047 ◽  
Author(s):  
Cristieli SM Oliveira ◽  
Patrícia Sampaio ◽  
Pascoal T Muniz ◽  
Marly A Cardoso ◽  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Vitamin A ◽  
Complementary Feeding ◽  
Intervention Group ◽  
Control Group ◽  
Primary Health ◽  
Micronutrient Status ◽  
Health Centres ◽  
Home Fortification

AbstractObjectiveWe evaluated the effect of home fortification with multiple micronutrient powder (MNP) on anaemia and micronutrient status of young Amazonian children.DesignA pragmatic controlled trial was performed. A control group (CG) of children aged 11–14 months was recruited in the routine of primary health-care centres for assessing anaemia and micronutrient status. At the same time, an intervention group (IG) of infants aged 6–8 months was recruited in the same health centres to receive MNP daily in complementary feeding for 2 months. The IG children were assessed 4–6 months after enrolment (n112) when they had reached the age of the CG participants (n128) for comparisons.SettingPrimary health centres in Rio Branco city, Brazilian Amazon.SubjectsA total of 240 children aged<2 years.ResultsIn the CG, the prevalence of anaemia (Hb<110 g/l), iron deficiency (ID; plasma ferritin <12 μg/l or soluble transferrin receptor >8·3 mg/l) and vitamin A deficiency (VAD; serum retinol <0·70 μmol/l) was 20·3 %, 72·4 % and 18·6 %, respectively. Among the IG participants (aged 11–14 months), the prevalence of anaemia, ID and VAD was 15·2 %, 25·2 % and 4·7 %, respectively. The IG had a lower likelihood of ID (prevalence ratio (95 % CI): 0·34 (0·24, 0·49)) and VAD (0·25 (0·09, 0·64)).ConclusionsHome fortification of complementary feeding delivered through primary health care was effective in reducing iron and vitamin A deficiencies among young Amazonian children.

Effectiveness of a Primary Health Care Program on Urban and Rural Community Disaster Preparedness, Islamic Republic of Iran: A Community Intervention Trial

2013 ◽  
Vol 7 (5) ◽  
pp. 481-490 ◽  
Author(s):  
Ali Ardalan ◽  
Hani Mowafi ◽  
Hossein Malekafzali Ardakani ◽  
Farid Abolhasanai ◽  
Ali-Mohammad Zanganeh ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Educational Intervention ◽  
Disaster Preparedness ◽  
Community Intervention ◽  
Control Group ◽  
Intervention Trial ◽  
Primary Health ◽  
And Control

AbstractBackgroundTo evaluate the effectiveness of a capacity-building intervention administered through a primary health care (PHC) system on community disaster preparedness in Iran.MethodsA controlled community intervention trial with pre- and postassessments was conducted in 2011 in 3 provinces of Iran. In each province, 2 areas were chosen and randomly selected as an intervention or control group. A total of 9200 households were in the intervention area and 10 010 were in the control area. In each study group in each province 250 households were sampled for pre- and postassessment surveys. Community health volunteers led by PHC staff administered an educational intervention covering elements of hazard awareness and preparedness, with a focus on earthquakes and floods. Relative changes for awareness and readiness scores were assessed to demonstrate changes in outcome variables from pre- to postassessments in intervention and control groups. An effectiveness test of significance was based on interaction between time and area.ResultsHouseholds in intervention communities exhibited improved disaster awareness and readiness with respect to all outcome measures. Relative changes in awareness in intervention and control areas were 2.94 and -0.08, respectively (P < .001). Relative changes for readiness scores were 5.52 in intervention areas and 0.56 in control areas (P < .001). Relative changes for awareness and readiness were significantly correlated with a community's baseline risk perception and previous experience with natural disasters (P < .001).ConclusionsAn educational intervention administered through the PHC system effectively improved disaster awareness and readiness at a community level. For sustainability, community disaster reduction programs must be integrated into routine public health service delivery. (Disaster Med Public Health Preparedness. 2013;7:481-490)

scholarly journals Self-reported sick leave following a brief preventive intervention on work-related stress

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
A-M Hultén ◽  
P Bjerkeli ◽  
K Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sick Leave ◽  
Brief Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Work Related Stress ◽  
Work Related ◽  
Primary Health ◽  
Related Stress

Abstract Background General practitioners (GPs) play an important role for early identification and prevention of sick leave among patients perceiving ill health due to work-relates stress. In order to fulfil the role, they need adequate methodologies and tools. This study aimed to evaluate the effectiveness of a brief intervention in primary health care including early identification of work-related stress combined with feedback at consultation on the number of self-reported sick leave days. Methods A randomised controlled trial was performed at seven primary health care centres in western Sweden. Self-reported sick leave data collected between November 2015 and January 2017 were analysed prospectively. The study included 271 employed, non-sick-listed patients aged 18-64 years seeking care for mental and/or physical health complaints. The intervention group received a brief intervention about work-related stress, including training for GPs, screening of patients' work-related stress, feedback to patients on screening results and discussion of measures at GP consultation. The control group received treatment as usual. Results At 6-month follow-up 59/105 (56%) in the intervention group and 61/115 (53%) in the control group reported no sick leave. At 12-month follow-up the corresponding numbers were 61/119 (51%) and 57/122 (47%) respectively. There were no statistically significant differences between the intervention group and the control group in the median number of self-reported sick leave days. Conclusions The brief intervention showed no effect on the numbers of self-reported sick leave days. However, using sick leave as an outcome measure was difficult, as sick leave is multifactorial and the data has a non-normal distribution. In addition, sick leave might be used as an indicator as well as a possible treatment of ill health. Other actions and interventions to address patients perceiving ill health due to work-related stress should be explored. Key messages Sick leave is used as an indicator and as a treatment of ill health, which can complicate the evaluation of studies. The complexity of primary health care trials calls for other evaluation methods.

Training General Practitioners in Evidence-Based Tobacco Treatment: An Evaluation of the Tobacco Treatment Training Network in Crete (TiTAN-Crete) Intervention

2018 ◽  
Vol 45 (6) ◽  
pp. 888-897 ◽  
Author(s):  
Charis Girvalaki ◽  
Sophia Papadakis ◽  
Constantine Vardavas ◽  
Andrew L. Pipe ◽  
Eleni Petridou ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Intervention Group ◽  
Future Research ◽  
Control Group ◽  
Evidence Based ◽  
Cross Sectional ◽  
Training Interventions ◽  
Tobacco Treatment ◽  
Patient Reported ◽  
Quasi Experimental

Background. Rates of tobacco treatment delivery in primary care are suboptimal. Aims. We report on the effectiveness of the TiTAN Crete intervention on rates of patient-reported 4As (ask, advise, assist, arrange) tobacco treatment and general practitioner’s (GP) knowledge, attitudes, self-efficacy, and intentions. Methods. A quasi-experimental pilot study with pre-post evaluation was conducted in Crete, Greece (2015-2016). GPs ( n = 24) intervention and control group and a cross-sectional sample of their patients ( n = 841) were surveyed before the implementation of the intervention. GPs in the intervention group received training, practice, and patient tools to support the integration of the 4As treatment into clinical routines. Intervention group GPs ( n = 14) and a second cross-sectional sample of patients ( n = 460) were surveyed 4 months following the intervention to assess changes in outcomes of interest. Multilevel modeling was used to analyze data. Results. Among GPs exposed to the intervention, significant increases in knowledge, self-efficacy, and rates of 4As delivery were documented between the pre- and postassessment and compared with those of the control group. Specifically, the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for 4As delivery between the pre-and postassessment among GPs exposed to the TiTAN intervention were as follows: Ask AOR 3.66 (95% CI [2.61, 5.14]); Advise AOR 4.21 (95% CI [3.02, 5.87]); Assist AOR 13.10 (95% CI [8.83, 19.42]) and Arrange AOR 4.75 (95% CI [2.67, 8.45]). Conclusion. We found significant increases in rates at which GPs delivered evidence-based tobacco treatment following exposure to the TiTAN intervention. Future research should examine methods for supporting broader dissemination of well-designed training interventions in general practice.

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