Evaluation of a training program of hypertension for accredited social health activists (ASHA) in rural India.
Evaluation of a training program of hypertension for accredited social health activists (ASHA) in rural India.
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DOI：
10.1186/s12913-018-3140-8
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发表时间：
2018-05-02
影响因子：
2.8
通讯作者：
Joshi R
中科院分区：
文献类型：
--
作者：
Abdel-All M;Thrift AG;Riddell M;Thankappan KRT;Mini GK;Chow CK;Maulik PK;Mahal A;Guggilla R;Kalyanram K;Kartik K;Suresh O;Evans RG;Oldenburg B;Thomas N;Joshi R
高血压是心血管疾病的主要危险因素，是印度过早死亡和残疾的主要原因。由于印度农村地区获得卫生服务的机会很差，而且印度各地都有经过认证的社会卫生活动家（ASHA）负责孕产妇和儿童健康，因此改善高血压控制的一个潜在解决方案是利用这一现有劳动力。我们的目标是开发和实施一个培训包，为ASHA识别和控制高血压在社区，并评估培训计划的有效性，使用柯克帕特里克评估模型。该培训计划是一项为期3个月的干预措施的群集随机可行性试验的一部分，以改善印度南部的高血压结局。培训材料包括管理高血压，目标设定，促进小组会议以及如何测量血压和体重的细节。15名ASHA参加了一个为期五天的培训讲习班，该讲习班采用互动式教学策略。然后，ASHA领导社区教育支持小组3个月。采用柯克帕特里克的评价模型对培训进行了评价，该模型利用基线、培训后和干预后的知识测试、会议期间的表现观察和干预后的访谈来衡量反应、学习、行为和结果。ASHA的高血压知识从基线时的平均得分64%提高到培训后的76%和3个月干预后的84%。观察社区会议的研究官员报告说，ASHA在没有额外援助的情况下有效地提供了自我管理内容。ASHA报告说，培训材料易于理解，对教育社区成员很有用。ASHA可以接受培训，领导以社区为基础的小组教育讨论，并支持个人管理高血压。可行性试验已在印度临床试验注册中心（CTRI）注册，CTRI/2016/02/006678（2016年2月25日）。本文的在线版本（10.1186/s12913-018-3140-8）包含补充材料，可供授权用户使用。
Hypertension is a major risk factor for cardiovascular disease, a leading cause of premature death and disability in India. Since access to health services is poor in rural India and Accredited Social Health Activists (ASHAs) are available throughout India for maternal and child health, a potential solution for improving hypertension control is by utilising this available workforce. We aimed to develop and implement a training package for ASHAs to identify and control hypertension in the community, and evaluate the effectiveness of the training program using the Kirkpatrick Evaluation Model. The training program was part of a cluster randomised feasibility trial of a 3-month intervention to improve hypertension outcomes in South India. Training materials incorporated details on managing hypertension, goal setting, facilitating group meetings, and how to measure blood pressure and weight. The 15 ASHAs attended a five-day training workshop that was delivered using interactive instructional strategies. ASHAs then led community-based education support groups for 3 months. Training was evaluated using Kirkpatrick’s evaluation model for measuring reactions, learning, behaviour and results using tests on knowledge at baseline, post-training and post-intervention, observation of performance during meetings and post-intervention interviews. The ASHAs’ knowledge of hypertension improved from a mean score of 64% at baseline to 76% post-training and 84% after the 3-month intervention. Research officers, who observed the community meetings, reported that ASHAs delivered the self-management content effectively without additional assistance. The ASHAs reported that the training materials were easy to understand and useful in educating community members. ASHAs can be trained to lead community-based group educational discussions and support individuals for the management of high blood pressure. The feasibility trial is registered with the Clinical Trials Registry - India (CTRI) CTRI/2016/02/006678 (25/02/2016). The online version of this article (10.1186/s12913-018-3140-8) contains supplementary material, which is available to authorized users.
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