Strengthening primary care systems for prevention & control of cardiovascular diseases in Kenya: feasibility study of health kiosks in markets

加强预防初级保健系统

• 批准号: MR/S009035/1
• 负责人: Seeromanie Harding
• 金额: $ 45.34万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FS009035%2F1
• 关键词: Strengthening; primary; care; systems; prevention

Non-communicable diseases (NCDs), including cardiovascular diseases (CVD) and type 2 diabetes, are a major challenge to healthcare. NCD-risk factors include raised blood pressure, diabetes, high cholesterol, smoking, and obesity. In Kenya, CVDs are the leading cause of NCD-mortality. Rising CVD-related mortality is related to ageing populations, urbanization, lifestyle changes such as unhealthy diets, lack of exercise, alcohol consumption, smoking and other environmental and social factors. The effect of these factors on health are worse in poor communities and health systems face growing challenges meeting the needs of those affected. Lack of access to health systems (e.g. primary care centres) is problematic in low-middle income countries such as Kenya. Sustainable, community-based initiatives that interface with health systems may offer a unique route to address lack of access. There is a scarcity of these initiatives, particularly in resource poor areas. Community markets are social establishments with untapped potential to promote public health messages and interventions for CVD. The Kenya Medical Research Institute (KEMRI), in collaboration with University of Nairobi, Moi University, Strathmore University and King's College London, will investigate whether Health Kiosks, manned by community health workers (CHWs) and nurses, in community markets can support prevention and management of CVD.The study will take place in Vihiga County, which faces a shortage of physicians and nurses and the challenge of providing high quality care. We will work with the county's local market traders to identify local champions to promote use of the kiosks. CHWs will be trained to conduct simple tests to assess CVD risk such as measuring blood pressure, weight, encourage people to take medication as prescribed, follow prescribed treatments and attend clinic appointments, and support behaviour change for more active lifestyle such as providing exercise plans. CHWs will be supervised by nurses who will provide feedback, probable 'diagnosis' and make referrals. Market champions will promote kiosk engagement in the community.We will also gather information on health outcomes, which together with the other findings from this study will help us plan future large-scale studies of the effectiveness of nurse and CHW-led Health Kiosks in local markets. We will conduct real-time evaluation to look at how the intervention works and for whom. If successful, the research will support guidance on how the Kenyan health system and communities can work together to combat NCDs. Transformation of the current health systems in this way will reach more vulnerable people than through the current model by providing accessible and regular health advice and support in the local community. If successful it will result in significant social and economic benefits by reducing health care costs and preventing morbidity and premature death from CVD.

非传染性疾病（NCD），包括心血管疾病（CVD）和2型糖尿病，是医疗保健的主要挑战。非传染性疾病的风险因素包括高血压、糖尿病、高胆固醇、吸烟和肥胖。在肯尼亚，心血管疾病是非传染性疾病死亡的主要原因。心血管疾病相关死亡率的上升与人口老龄化、城市化、生活方式的改变（如不健康的饮食、缺乏锻炼、饮酒、吸烟和其他环境和社会因素）有关。这些因素对健康的影响在贫穷社区更为严重，卫生系统在满足受影响者的需求方面面临越来越大的挑战。在肯尼亚等中低收入国家，缺乏获得保健系统（如初级保健中心）的机会是一个问题。可持续的、以社区为基础的倡议与卫生系统相结合，可能是解决缺乏机会问题的独特途径。这类举措很少，特别是在资源贫乏的地区。社区市场是具有未开发潜力的社会设施，可促进公共卫生信息和心血管疾病干预措施。肯尼亚医学研究所（KEMRI）与内罗毕大学、莫伊大学、斯特拉斯莫尔大学和伦敦国王学院合作，将调查社区市场上由社区卫生工作者（CHW）和护士管理的健康亭是否可以支持心血管疾病的预防和管理。它面临着医生和护士短缺以及提供高质量护理的挑战。我们将与该县当地市场的贸易商，以确定当地的冠军，以促进使用亭。社区卫生工作者将接受培训，进行简单的测试，以评估心血管疾病的风险，如测量血压，体重，鼓励人们按照规定服用药物，遵循规定的治疗和参加诊所预约，并支持更积极的生活方式的行为改变，如提供锻炼计划。CHW将由护士监督，护士将提供反馈、可能的“诊断”和转诊。我们还将收集有关健康结果的信息，这些信息与本研究的其他发现一起将有助于我们计划未来对护士和CHW领导的健康亭在当地市场的有效性进行大规模研究。我们将进行实时评估，以了解干预措施如何发挥作用以及对谁有效。如果成功，这项研究将支持指导肯尼亚卫生系统和社区如何共同努力防治非传染性疾病。以这种方式改革目前的卫生系统，通过在当地社区提供方便和定期的卫生咨询和支助，将比通过目前的模式接触到更多的弱势群体。如果成功，它将通过降低医疗保健成本和预防心血管疾病的发病率和过早死亡而产生重大的社会和经济效益。

项目成果

Formative Exploration of the Feasibility of Embedding Community Assets Into Primary Health Care: Barbershop and Place of Worship Readiness in Guyana.

• DOI: 10.1177/21501319221135949
• 发表时间: 2022-01
• 期刊: JOURNAL OF PRIMARY CARE AND COMMUNITY HEALTH
• 影响因子: 3.6
• 作者: Goberdhan, Sharlene;Gobin, Reeta;Perreira, Olly;Sharma, Manoj;Ramdeen, Melissa;Harding, Seeromanie
• 通讯作者: Harding, Seeromanie

Acceptability and Feasibility of Community Gardening Interventions for the Prevention of Non-Communicable Diseases among Indigenous Populations: A Scoping Review.

• DOI: 10.3390/nu15030791
• 发表时间: 2023-02-03
• 期刊: Nutrients
• 影响因子: 5.9
• 作者: Emmanuel R;Read UM;Grande AJ;Harding S
• 通讯作者: Harding S

Adolescent Obesity Prevention in Saudi Arabia: Co-identifying Actionable Priorities for Interventions.

• DOI: 10.3389/fpubh.2022.863765
• 发表时间: 2022
• 期刊: FRONTIERS IN PUBLIC HEALTH
• 影响因子: 5.2
• 作者: Almughamisi, Manal;O'Keeffe, Majella;Harding, Seeromanie
• 通讯作者: Harding, Seeromanie

Contextually appropriate communication strategies for COVID-19 prevention in Kenya border regions: evidence from a mixed methods observational study in Busia and Mandera counties.

• DOI: 10.1136/bmjopen-2022-062686
• 发表时间: 2023-05-16
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: Kaduka, Lydia;Olale, Joanna;Karamanos, Alexis;Mutai, Joseph;Coultas, Clare;Ahmed, Ismail;L'Esperance, Veline;Read, Ursula;Dazzan, Paola;Cruickshank, John Kennedy;Muniu, Erastus;Harding, Seeromanie
• 通讯作者: Harding, Seeromanie

sj-pdf-1-jpc-10.1177_21501319221135949 - Supplemental material for Formative Exploration of the Feasibility of Embedding Community Assets Into Primary Health Care: Barbershop and Place of Worship Readiness in Guyana

sj-pdf-1-jpc-10.1177_21501319221135949 - 将社区资产嵌入初级卫生保健的可行性的补充材料：圭亚那的理发店和礼拜场所准备情况

• DOI: 10.25384/sage.21558433
• 发表时间: 2022
• 作者: Goberdhan S