Using Portable Health Information Kiosk to assess chronic disease burden in remote settings.
Using Portable Health Information Kiosk to assess chronic disease burden in remote settings.
复制标题
使用便携式健康信息亭评估偏远地区的慢性疾病负担。
作者：
A. Joshi;D. P. Puricelli Perin;M. Arora
简介
癌症、心血管疾病、慢性呼吸道疾病和 2 型糖尿病导致全球死亡率超过 50%。慢性病对发展中国家具有广泛的负面影响。久坐的生活方式、不良的营养和饮食习惯以及空气污染等风险因素是导致慢性病发生的因素。这些也在大大增加，肥胖已成为一种全球现象。健康促进以及慢性病预防和监测可以通过信息和通信技术（ICT）来实现，信息通信技术以电子方式获取、传播和存储与健康相关的信息。便携式健康信息亭（PHIK）可以成为促进城乡社区健康教育的有力工具。该研究的目的是利用 PHIK 作为工具来评估印度不同环境下的慢性病负担和相关风险因素。
方法
从城市、农村和部落等三个不同地理位置招募了便利样本，以探索 PHIK 在社区环境中进行慢性病健康风险评估的用途。横截面数据是在 2010 年 3 月至 5 月期间在印度奥里萨邦的 Rourkela 和布巴内斯瓦尔记录的。参与者被要求使用触摸屏电子信息亭来收集主观和客观数据，以了解社区环境中慢性病的负担和相关风险。主观数据包括对一系列多项选择题的回答，客观数据是使用体重、血糖和血压等多个生理传感器收集的。使用单变量统计进行描述性分析，连续变量的结果报告为平均值和标准差，而分类变量的结果则酌情报告为频率统计。
结果
共有 429 名 18 岁及以上的参与者参加了三种不同的社区环境：城市、贫民窟和部落。与居住在贫民窟 (p=0.04) 或部落 (p=0.02) 的人相比，居住在城市的人的收缩压存在显着差异。与城市环境相比，仅生活在部落的人的血糖水平存在显着差异（p=0.04）。结果显示，居住在贫民窟和部落地区的人群中，高血压前期、1 期和 2 期高血压患病率较高。
结论
结果显示部落和贫民窟社区存在慢性疾病。对这些人群的慢性健康状况的评估是不够的。基础设施薄弱和缺乏合格的人员是提供有意义的服务的挑战，因为低工资、恶劣的生活和工作条件阻碍了训练有素的劳动力在这些极度需要的领域立足。健康亭可以是一个多方面的解决方案，因为它们可以用来评估由于缺乏基础设施或卫生人员而通常无法覆盖的地区的健康结果，建立健康教育模块并向当地居民通报这些信息。它们可以支持国家和区域计划和政策的循证决策。
INTRODUCTION
Cancer, cardiovascular disease, chronic respiratory disease, and type 2 diabetes, are responsible for over 50% of worldwide mortality. Chronic diseases have broad negative impacts in developing countries. Contributing to the development of chronic diseases are sedentary lifestyles, poor nutrition and eating habits, and air pollution, among other risk factors. These are also greatly increasing, and obesity has become a global phenomenon. Health promotion, and chronic disease prevention and surveillance, can be achieved through information and communication technologies (ICT), which acquire, disseminate and store health-related information electronically. The portable health information kiosk (PHIK) can be a powerful tool for promoting health education in communities in both urban and rural settings. The objective of the study was to utilize a PHIK as a tool to assess the burden of chronic disease and associated risk factors in diverse settings in India.
METHODS
A convenience sample was enrolled from three diverse geographical locations including urban, rural and tribal to explore the utilization of a PHIK for chronic disease health risk assessment in a community setting. Cross-sectional data was recorded during the period of March-May 2010 in Rourkela and Bhubaneswar in the state of Orissa, India. Participants were asked to use a touch screen, electronic kiosk that gathered subjective and objective data to understand the burden of chronic diseases and associated risk in the community setting. The subjective data included responses to a series of multiple-choice questions and the objective data was gathered using multiple physiological sensors such as weight, blood sugar and blood pressure. Descriptive analysis was performed using univariate statistics with results for the continuous variables being reported as means and standard deviations while results for the categorical variables were reported as frequency statistics as appropriate.
RESULTS
A total of 429 participants aged 18 years and older were enrolled in three different community settings: urban, slum and tribal. Significant differences were seen in the systolic blood pressure of those living in the urban settings as compared with those living in either slum (p=0.04) or tribal settings (p=0.02). Significant differences in the blood sugar levels were seen only among those living in the tribal as compared with the urban settings (p=0.04). Results showed high prevalence of pre-hypertension, stages 1 and 2 hypertension among those living in the slum and tribal settings.
CONCLUSIONS
The results show the presence of chronic diseases in tribal and slum communities. The assessment of chronic health conditions in these populations is insufficient. Poor infrastructure and lack of qualified personnel are challenges to providing a meaningful service, as low wages, poor living and working conditions are obstacles that prevent the trained workforce from establishing themselves in these areas of extreme need. Health kiosks can be a multifaceted solution, as they can be used to assess health outcomes in areas that normally are not covered due to lack of infrastructure or health personnel, to establish health education modules and inform the local population about them. They can support evidence-based decisions for national and regional programs and policies.