scholarly journals An integrated community-based hypertension improvement program improves hypertension awareness in Ghana

2021 ◽  
Vol 3 ◽  
Author(s):  
Amos K. Laar ◽  
Alma J. Adler ◽  
David Prieto-Merino ◽  
Reina M.M. Der ◽  
Deborah Mangortey ◽  
...  
Keyword(s):  
Improvement Program ◽  
Community Based ◽  
Hypertension Awareness

scholarly journals Hypertension Prevalence Based on Blood Pressure Measurements on Two vs. One Visits: A Community-Based Screening Programme and a Narrative Review

2020 ◽  
Vol 17 (24) ◽  
pp. 9395
Author(s):  
Chloé Plumettaz ◽  
Bharathi Viswanathan ◽  
Pascal Bovet
Keyword(s):  
Blood Pressure ◽  
Screening Programme ◽  
Narrative Review ◽  
Community Surveys ◽  
Community Based ◽  
Public Places ◽  
Hypertension Awareness ◽  
The Difference ◽  
And Control ◽  
Untreated Individuals

We assessed the difference in the prevalence of hypertension in community surveys when blood pressure (BP) was measured on two vs. one visits and its impact on hypertension awareness, treatment and control proportions. A community-based BP screening programme was conducted in public places in the Seychelles (619 adults) and BP was rechecked a few days later among untreated participants with high BP (≥140/90 mmHg). A narrative review of the literature on this question was also conducted. Only 64% of untreated participants with high BP still had high BP at the second visit. The prevalence of hypertension in the whole sample decreased by 13% (from 33.8% to 29.5%) when BP was measured on two vs. one visits. These results concurred with our findings in our narrative review based on 10 surveys. In conclusion, the prevalence of hypertension can be markedly overestimated in community surveys when BP is measured on two vs. one visits. The overestimation could be addressed by measuring BP on a second visit among untreated individuals with high BP or, possibly, by taking more readings at the first visit. These findings have relevance for clinical practice, policy and surveillance.

scholarly journals Chagas disease prevention through improved housing using an ecosystem approach to health

2001 ◽  
Vol 17 (suppl) ◽  
pp. S89-S97 ◽  
Author(s):  
Antonieta Rojas-de-Arias
Keyword(s):  
Disease Prevention ◽  
Chagas Disease ◽  
Community Education ◽  
Ecosystem Approach ◽  
Improvement Program ◽  
Community Based ◽  
Environmental Interventions ◽  
Community Based Research ◽  
Housing Improvement ◽  
Prevention Project

This Chagas disease prevention project via housing improvement aims to determine the efficiencyof different interventions in vector control. The following study describes the target communities, disease magnitude, and housing improvements. Transmission levels are analysed from an ecological and socioeconomic perspective. Special interest was focused on the peridomicile as the origin of domiciliary reinfestation. In the original project, three intervention programs were proposed, one for each of the three communities: (a) an insecticide spraying program; (b) a housing improvement program; and (c) a combined program of spraying and housing improvement. The three communities currently have different risks of exposure to triatominae reinfestation as a consequence of the type of intervention carried out. A new multidisciplinary approach which integrates participatory, community-based research and socioeconomic dimensions will allow to determine the efficiency of models for territorial ordering, community education, and environmental interventions in Chagas disease control.

Outcome of Community Based Hypertension awareness activity in the field practice area of KBNIMS, Kalaburagi

2019 ◽  
Vol 9 (2) ◽  
pp. 43-46
Author(s):  
Mujeeburehman Mujahid ◽  
◽  
Mohd Abdul Baseer ◽  
N D Bendigeri ◽  
◽  
...  
Keyword(s):  
Community Based ◽  
Field Practice ◽  
Hypertension Awareness

Effectiveness of a Community-Based Exercise Program on Balance Performance and Fear of Falling in Older Nonfallers at Risk for Falling: A Randomized, Controlled Study

2016 ◽  
Vol 24 (4) ◽  
pp. 516-524 ◽  
Author(s):  
Yanan Zhao ◽  
Pak-Kwong Chung ◽  
Tomas K. Tong
Keyword(s):  
At Risk ◽  
Fear Of Falling ◽  
Dynamic Balance ◽  
Exercise Program ◽  
Controlled Study ◽  
Static Balance ◽  
Balance Performance ◽  
Improvement Program ◽  
Community Based ◽  
Significant Difference

This study evaluated the effectiveness of the community-based Exercise for Balance Improvement Program (ExBP) in improving dynamic balance (DB) and static balance with compromised sensations and reducing fear of falling (FF) among older nonfallers. Sixty-one participants (70 ± 3 years) at risk for falling were randomly allocated to receive ExBP practice for 16 weeks, Tai Chi (TC), or no treatment (CON) with an 8-week follow-up. The ExBP group exhibited significant improvements in DB (2.18, 95% CI = 1.16–3.19), static balance with compromised vision and somatosensation (ECSS; 0.46, 95% CI = 0.06–0.85), and FF (8.65, 95% CI = 0.52–16.8). After the intervention, the ExBP group showed significantly more improvement than did the CON group in DB, static balance with compromised somatosensation, and ECSS. No significant difference was observed between the ExBP and TC groups. Therefore, the ExBP can be applied as an effective alternative exercise regimen for improving balance and fall efficacy for older nonfallers.

scholarly journals Long-term effectiveness of the community-based Complete Health Improvement Program (CHIP) lifestyle intervention: a cohort study

BMJ Open ◽  
2013 ◽  
Vol 3 (11) ◽  
pp. e003751 ◽  
Author(s):  
Lillian Kent ◽  
Darren Morton ◽  
Trevor Hurlow ◽  
Paul Rankin ◽  
Althea Hanna ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lifestyle Intervention ◽  
Health Improvement ◽  
Improvement Program ◽  
Community Based ◽  
Complete Health

scholarly journals Understanding What Influences Community-Based Care Coordination Improvement: Interpreting Variation in a Medicare Hospital Readmissions Reduction Program Using the Consolidated Framework for Implementation Research (CFIR)

2020 ◽  
Author(s):  
Jane Brock ◽  
Brianna Gass ◽  
Alaina Brothersen ◽  
Lacey McFall ◽  
Kati Walsh ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Care Coordination ◽  
Hospital Readmissions ◽  
Successful Implementation ◽  
Readmission Rates ◽  
Improvement Program ◽  
Community Based ◽  
Implementation Framework ◽  
National Quality ◽  
Outer Setting

Abstract Background Quality Improvement Networks Quality Improvement Organizations (QIN-QIOs) developed community coalitions to align care coordination efforts for Medicare beneficiaries in order to reduce readmission rates within geographically defined communities. This CMS (Centers for Medicare & Medicaid Services) funded national quality improvement program worked with 380 coalitions from 2014-2019, facilitating a variety of interventions within each community. Baseline readmission rates among communities, calculated from claims data, varied from 17.7 to 112 readmissions/1000 beneficiaries. Program results ranged from +40.7% (high performance) to -35.8% (low performance) relative improvement.We applied an implementation framework (CFIR) to the QIN-QIO efforts to define common characteristics of interventions, implementation strategies, and contexts in which improvement efforts took place. We identify features associated with successful and unsuccessful intervention implementation, and with changes in readmission rates.Methods We selected 22 communities representing a range of relative improvement, geographic characteristics and baseline readmissions rates. We measured the QIN-QIO’s perception of influence of individual CFIR constructs on community readmission rates over time using a written assessment and elicited details and mechanisms through structured interviews. Two independent reviewers qualitatively coded transcribed interviews. Final ratings for the influence of each CFIR construct on community performance were assigned by consensus, ranging from -2 (strong negative influence) to +2 (strong positive influence).Results Some adaptation of the CFIR, such including codes in a coalition domain, and adding constructs to the outer setting domain, such as healthcare market characteristics, helped fit the framework to the QIN-QIO work. The characteristics of individuals domain was less applicable to this study. Several constructs were found to be associated with improvement, or lack of, in readmission rates in communities.Conclusions The CFIR is an appropriate taxonomy for understanding implementation of care coordination interventions in the QIN-QIO communities, with constructs from the Outer Setting and Process domains having the most influence on successful implementation. Communities effectively reducing readmissions had coalitions with favorable implementation climates, robust stakeholder engagement strategies, and interventions aligned with local concerns and capabilities. The CFIR can help guide, monitor and evaluate community-based improvement initiatives, although further development some constructs is needed.

scholarly journals Health system challenges to hypertension and related non-communicable diseases prevention and treatment: perspectives from Ghanaian stakeholders

2019 ◽  
Author(s):  
Amos K. Laar ◽  
Alma J. Adler ◽  
Agnes M. Kotoh ◽  
Helena Legido-Quigley ◽  
Isabelle L. Lange ◽  
...  
Keyword(s):  
Health System ◽  
National Level ◽  
Healthcare Providers ◽  
Significant Risk ◽  
System Level ◽  
Task Sharing ◽  
Improvement Program ◽  
Community Based ◽  
Prevention And Treatment ◽  
Policy Level

Abstract Background Hypertension, itself a cardiovascular condition, is a significant risk factor for other cardiovascular diseases. Hypertension is recognised as a major public health challenge in Ghana. Beginning in 2014, a collaborative team launched the community-based hypertension improvement program (ComHIP) in one health district in Ghana. The ComHIP project, a public-private partnership, tests a community-based model that engages the private sector and utilizes information and communication technology (ICT) to control hypertension. This paper, however, focuses on the various challenges associated with managing hypertension in Ghana, as reported by ComHIP stakeholders. Methods A total of 55 informants – comprising patients, health care professionals, licensed chemical sellers (LCS), national and sub-national policy makers – were purposively selected for interview and focus group discussions (FGDs). Interviews were audio-recorded and transcribed verbatim. Where applicable, transcriptions were translated directly from local language to English. The data were then analysed using two-step thematic analysis. The protocol was approved by the two ethics review committees based in Ghana and the third, based in the United Kingdom. All participants were interviewed after informed consent. Results Our data have implications for the on-going implementation of ComHIP, especially the importance of policy maker buy-in, the benefits, as well as drawbacks of the program to different stakeholders. While our data show that the ComHIP initiative is acceptable to patients and healthcare providers – increasing providers’ knowledge on hypertension and patients’ awareness of same, there were implementation challenges identified by both patients and providers. Policy level challenges relate to task-sharing bottlenecks, which precluded nurses from prescribing or dispensing antihypertensives, and LCS from stocking same. Medication adherence, and the phenomenon of medical pluralism in Ghana, were identified challenges. The perspectives from the national level stakeholders enable elucidation of whole of health system challenges to ComHIP and therefore similarly designed future programmes. Conclusions This paper sheds important light on the patient/individual, and system level challenges to hypertension and related non-communicable disease prevention and treatment in Ghana. The data show that although the ComHIP initiative is acceptable to patients and healthcare providers, policy level task-sharing bottlenecks preclude optimal implementation of ComHIP.

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