Acceptability and feasibility of home-based hypertension and physical activity screening by community health workers in an under-resourced community in South Africa

Stoutenberg, Mark; Crouch, Simone H.; McNulty, Lia K.; Kolkenbeck‐Ruh, Andrea; Torres, Georgia; Gradidge, Philippe Jean-Luc; Ly, Andy; Ware, Lisa J.

doi:10.1007/s10389-023-01873-w

Cited by 5 publications

(2 citation statements)

References 50 publications

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“…68 Some studies have also reported the effectiveness and feasibility of training CHWs to perform a cardiovascular risk assessment and BP measurement at primary-level healthcare centres in low-resource settings. 69 70 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of team-based care interventions in improving blood pressure outcomes among adults with hypertension in Africa: a systematic review and meta-analysis

Hinneh,

Boakye,

Metlock

et al. 2024

BMJ Open

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ObjectiveWe evaluated the effectiveness of team-based care interventions in improving blood pressure (BP) outcomes among adults with hypertension in Africa.DesignSystematic review and meta-analysis.Data sourcePubMed, CINAHL, EMBASE, Cochrane Library, HINARI and African Index Medicus databases were searched from inception to March 2023.Eligibility criteria for selecting studiesWe included randomised controlled trials (RCTs) and pre-post study designs published in English language focusing on (1) Adults diagnosed with hypertension, (2) Team-based care hypertension interventions led by non-physician healthcare providers (HCPs) and (3) Studies conducted in Africa.Data extraction and synthesisWe extracted study characteristics, the nature of team-based care interventions, team members involved and other reported secondary outcomes. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs and the National Heart, Lung, and Blood Institute assessment tool for pre-post studies. Findings were summarised and presented narratively including data from pre-post studies. Meta-analysis was conducted using a random effects model for only RCT studies. Overall certainty of evidence was determined using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool for only the primary outcome (systolic BP).ResultsOf the 3375 records screened, 33 studies (16 RCTs and 17 pre-post studies) were included and 11 RCTs were in the meta-analysis. The overall mean effect of team-based care interventions on systolic BP reduction was −3.91 mm Hg (95% CI −5.68 to −2.15, I² = 0.0%). Systolic BP reduction in team-based care interventions involving community health workers was −4.43 mm Hg (95% CI −5.69 to −3.17, I² = 0.00%) and nurses −3.75 mm Hg (95% CI −10.62 to 3.12, I² = 42.0%). Based on the GRADE assessment, we judged the overall certainty of evidence low for systolic BP reduction suggesting that team-based care intervention may result in a small reduction in systolic BP.ConclusionEvidence from this review supports the implementation of team-based care interventions across the continuum of care to improve awareness, prevention, diagnosis, treatment and control of hypertension in Africa.PROSPERO registration numberCRD42023398900.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of team-based care interventions in improving blood pressure outcomes among adults with hypertension in Africa: a systematic review and meta-analysis

Hinneh,

Boakye,

Metlock

et al. 2024

BMJ Open

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“…CHWs work across many different settings, such as local health clinics, community events, and are often utilized to conduct home visits. A recent study by Stoutenberg et al [26] demonstrated that CHW-led home visits to conduct health screenings in a low resource setting in SA were highly feasible (e.g., reaching a large number of households in a short period of time) and well accepted (>95% of households agreed to participate).…”

Section: The Role Of the Community Healthcare Workermentioning

confidence: 99%

Task-Shifting: Can Community Health Workers Be Part of the Solution to an Inactive Nation?

Watson,

Moosa,

Janse Van Rensburg

et al. 2023

IJERPH

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Background: In low-to-middle income countries (LMICs), there is a growing burden of non-communicable diseases (NCDs) placing strain on the facilities and human resources of healthcare systems. Prevention strategies that include lifestyle behavior counseling have become increasingly important. We propose a potential solution to the growing burden of NCDs through an expansion of the role for community health workers (CHWs) in prescribing and promoting physical activity in public health settings. This discussion paper provides a theoretical model for task-shifting of assessment, screening, counseling, and prescription of physical activity to CHWs. Five proposed tasks are presented within a larger model of service delivery and provide a platform for a structured, standardized, physical activity prevention strategy aimed at NCDs using CHWs as an integral part of reducing the burden of NCDs in LMICs. However, for effective implementation as part of national NCD plans, it is essential that CHWs received standardized, ongoing training and supervision on physical activity and other lifestyle behaviors to optimally impact community health in low resource settings.

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Physical activity vital sign assessment and associated health outcomes in an underserved South African community

Gradidge,

Crouch,

Thornton

et al. 2024

J Public Health (Berl.)

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Background Physical activity is particularly low in South Africa and contributes to chronic conditions. This study aimed to determine physical activity levels in a South African community, using the physical activity vital sign (PAVS), and identify associations between physical activity and key health outcomes. Methods A cross-sectional study used community health workers to collect PAVS data, blood pressure and self-reported medical history from 2282 participants living in Soweto, Johannesburg. Physical activity was defined as meeting or not meeting WHO guidelines of ≥ 150 min/week. Hypertension was defined according to the International Society of Hypertension guidelines. Results The study population included 1161 women and 1121 men. Administering the PAVS was quick (29.5 ± 43.4 s). Only 19.8% of the total population reported meeting the guidelines, and it was significantly lower in women (17.6%) compared with men (22.1%). The logistic regression models demonstrated significant association between not meeting physical activity guidelines and hypertension (adjusted odd ratio [AOR] 0.77, 95% CI 0.61–0.97, p = 0.032), current smoking (AOR 0.73, 95% CI 0.55–0.97, p = 0.030) and past smoking (AOR 0.61, 95% CI 0.44–0.83, p = 0.002). Conclusions This study demonstrates the validity of using the PAVS in an underserved community. The observed associations highlight the potential of advocating physical activity as a feasible intervention for improving the health of urban-dwelling Black South Africans.

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Acceptability and feasibility of home-based hypertension and physical activity screening by community health workers in an under-resourced community in South Africa

Cited by 5 publications

References 50 publications

Effectiveness of team-based care interventions in improving blood pressure outcomes among adults with hypertension in Africa: a systematic review and meta-analysis

Effectiveness of team-based care interventions in improving blood pressure outcomes among adults with hypertension in Africa: a systematic review and meta-analysis

Task-Shifting: Can Community Health Workers Be Part of the Solution to an Inactive Nation?

Physical activity vital sign assessment and associated health outcomes in an underserved South African community

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