Acceptability of patient-centered hypertension education delivered by community health workers among people living with HIV/AIDS in rural Uganda.


Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
07 07 2021
Historique:
received: 11 10 2020
accepted: 29 06 2021
entrez: 8 7 2021
pubmed: 9 7 2021
medline: 6 8 2021
Statut: epublish

Résumé

The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda. We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon's model of acceptability of health Interventions to explore participants' perceptions. Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material (PocketDoktor™) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor™, financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting. Hypertension patient-centered education delivered by CHWs using the PocketDoktor™ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.

Sections du résumé

BACKGROUND
The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda.
METHODS
We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon's model of acceptability of health Interventions to explore participants' perceptions.
RESULTS
Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material (PocketDoktor™) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor™, financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting.
CONCLUSIONS
Hypertension patient-centered education delivered by CHWs using the PocketDoktor™ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.

Identifiants

pubmed: 34233648
doi: 10.1186/s12889-021-11411-6
pii: 10.1186/s12889-021-11411-6
pmc: PMC8264981
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1343

Subventions

Organisme : FIC NIH HHS
ID : D43 TW010037
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW009340
Pays : United States

Références

PLoS One. 2016 May 27;11(5):e0156309
pubmed: 27232186
Med Educ. 2006 Apr;40(4):314-21
pubmed: 16573666
Hum Resour Health. 2018 Jan 6;16(1):2
pubmed: 29304869
N Engl J Med. 2005 Jan 6;352(1):48-62
pubmed: 15635112
J Educ Health Promot. 2020 Sep 28;9:228
pubmed: 33209920
PLoS One. 2013 Jul 12;8(7):e68794
pubmed: 23874767
AIDS Patient Care STDS. 2002 Jan;16(1):43-50
pubmed: 11839218
Int J Equity Health. 2019 Feb 28;18(1):38
pubmed: 30819193
Clin Infect Dis. 2010 Aug 15;51(4):435-47
pubmed: 20597691
PLoS One. 2018 Dec 31;13(12):e0208635
pubmed: 30596667
BMJ Glob Health. 2016 Nov 24;1(3):e000055
pubmed: 28588953
Ann Intern Med. 2009 Feb 3;150(3):178-87
pubmed: 19189907
Afr J Prim Health Care Fam Med. 2014 Nov 21;6(1):E1-8
pubmed: 26245419
PLoS One. 2015 Sep 25;10(9):e0138991
pubmed: 26406462
Can Fam Physician. 2012 Dec;58(12):1366-73
pubmed: 23242897
BMC Cardiovasc Disord. 2010 Dec 21;10:61
pubmed: 21172033
Health Policy Plan. 2018 Apr 1;33(3):328-334
pubmed: 29309578
JAMA. 2014 Feb 5;311(5):507-20
pubmed: 24352797
PLoS One. 2018 Aug 1;13(8):e0201001
pubmed: 30067823
Hum Resour Health. 2018 Nov 21;16(1):63
pubmed: 30463573
PLoS One. 2017 May 18;12(5):e0177535
pubmed: 28542317
BMC Public Health. 2015 Jan 29;15:33
pubmed: 25631224
Hum Resour Health. 2016 Oct 26;14(1):65
pubmed: 27784298
Med Care. 1999 Jan;37(1):5-14
pubmed: 10413387
Malar J. 2018 Feb 23;17(1):95
pubmed: 29475439
N Engl J Med. 2020 Feb 20;382(8):717-726
pubmed: 32074419
PLoS One. 2016 Nov 16;11(11):e0166411
pubmed: 27851785
BMC Health Serv Res. 2017 Jan 26;17(1):88
pubmed: 28126032
AIDS. 2018 Jul 1;32 Suppl 1:S5-S20
pubmed: 29952786
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
J Obstet Gynaecol. 2005 Jul;25(5):494-9
pubmed: 16183589
Prog Cardiovasc Dis. 2013 Nov-Dec;56(3):302-13
pubmed: 24267437
Front Psychiatry. 2020 Aug 14;11:778
pubmed: 32922314
PLoS One. 2019 Jun 6;14(6):e0217703
pubmed: 31170220
BMC Res Notes. 2019 Dec 18;12(1):812
pubmed: 31852520
PLoS One. 2016 Feb 22;11(2):e0149412
pubmed: 26901854
Malar J. 2007 Jan 26;6:11
pubmed: 17257396
Annu Rev Public Health. 2014;35:399-421
pubmed: 24387091
BMC Public Health. 2015 Aug 28;15:830
pubmed: 26315787
Health Policy Plan. 2012 Jul;27(4):288-300
pubmed: 21565939
Prev Chronic Dis. 2013;10:E26
pubmed: 23428085
Yearb Med Inform. 2015 Aug 13;10(1):30-3
pubmed: 26123907
Lancet. 2002 Nov 30;360(9347):1747-8
pubmed: 12480430
Ann N Y Acad Sci. 2008;1136:161-71
pubmed: 17954679
Health Policy Plan. 2012 Mar;27(2):115-26
pubmed: 21385799
J Res Med Sci. 2015 Jan;20(1):54-61
pubmed: 25767523

Auteurs

Charles Batte (C)

School of Medicine, Lung Institute, Makerere University College of Health Sciences, Upper Hill Mulago Hill, Kampala, Uganda. batchaux@gmail.com.

John Mukisa (J)

Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.

Natalie Rykiel (N)

Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA.
Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, USA.

David Mukunya (D)

Faculty of Health Sciences, Busitema University, Mbale, Uganda.

William Checkley (W)

Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA.
Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, USA.

Felix Knauf (F)

Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Robert Kalyesubula (R)

School of Medicine, Lung Institute, Makerere University College of Health Sciences, Upper Hill Mulago Hill, Kampala, Uganda.

Trishul Siddharthan (T)

Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA.
Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, USA.

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