Role development of community health workers for cardiovascular disease prevention in India
Role development of community health workers for cardiovascular disease prevention in India
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DOI：
10.1016/j.evalprogplan.2018.01.006
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发表时间：
2018-04-01
影响因子：
1.6
通讯作者：
Webel, Allison
中科院分区：
文献类型：
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作者：
Khetan, Aditya;Patel, Toral;Webel, Allison
心血管疾病（CVD）是印度死亡的主要原因。由于社区卫生工作者（chw）历来在改善孕产妇和儿童健康方面发挥了关键作用，因此人们假设他们有可能减轻心血管疾病在印度等国家的影响。SEHAT项目是一项聚类随机对照试验，旨在检验CHWs可以改善印度西孟加拉邦一个社区心血管危险因素控制的假设。本研究旨在定量评估SEHAT项目招募的卫生保健员的培训结果，并定性评估他们的招聘、培训和实地工作经验。招募chw的过程分为两步：笔试和面试。培训结束后，对他们的知识和经验进行评估。所有干预的保健护士在知识测试中得分为80分，这表明他们的知识保留率很高。焦点小组讨论的主要议题包括对两步招聘程序的满意程度、对沟通技巧的重视程度、在培训中使用视听辅助工具的偏好，以及认识到支持性监管框架的重要性。来自社会的尊重和对他人的积极影响一直被认为是这份工作最令人满意的方面，其次是经济补偿。在诸如印度等国家，心血管疾病项目中卫生工作者的招聘和培训过程应该更加标准化，以实现可复制性、可扩展性和充分评估其降低心血管疾病死亡率的潜力。
Cardiovascular disease (CVD) is the leading cause of mortality in India. Since community health workers (CHWs) have historically played a pivotal role in improving maternal and child health, it has been hypothesized that they have the potential to mitigate the impact of CVD in countries such as India. Project SEHAT is a cluster RCT to test the hypothesis that CHWs can improve the control of cardiovascular risk factors in a community in West Bengal, India. This study sought to quantitatively assess the training outcomes of CHWs recruited for Project SEHAT, and qualitatively assess their recruitment, training and fieldwork experiences.CHWs were recruited through a 2 step process-a written test and an interview. Upon completion of training, their knowledge and experiences were assessed. All intervention CHWs scored >80% on the knowledge test, implying a high rate of knowledge retention. Important themes identified during a focus group discussion with CHWs included satisfaction with a 2 step recruitment process, emphasis on communication skills, a preference for audio-visual aids in training and recognition of the importance of a supportive supervisory framework. Respect from society and a positive impact on people was consistently cited as the most satisfying aspects of the job, followed by financial compensation.Recruitment and training processes for CHWs in CVD programs should be more standardized to enable replication, scalability and adequate assessment of their potential to mitigate CVD mortality in countries such as India.