Thankappan K R, Sivasankaran S, Mini G K, Daivadanam Meena, Sarma P S, Abdul Khader S
Professor and Head, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
Indian Heart J. 2013 Sep-Oct;65(5):504-9. doi: 10.1016/j.ihj.2013.08.023. Epub 2013 Aug 31.
Community based intervention to control hypertension is extremely limited in India. We conducted this study to find the effectiveness of a community based intervention program on the awareness, treatment and control of hypertension.
A baseline survey was conducted among 4627 adults aged ≥30 years (men 44%) selected by cluster sampling. Information was collected using a structured interview schedule by trained local volunteers. They measured weight, height, waist circumference and blood pressure using standard protocol. The volunteers monitored blood pressure at least once a month and educated the people in neighborhood groups on the need for regular medication and reducing risk factors of hypertension for a period of six years. A post intervention survey was conducted among 2263 adults aged ≥30 years (men 49%). Stepwise logistic regression analysis was done to find the odds of change in awareness, treatment and control of hypertension.
The odds of awareness (OR 4.18, 95% CI 3.44-5.08), treatment (OR 3.44 CI 2.81-4.22) and control (OR 4.39 CI 3.36-5.73) of hypertension increased significantly in the post intervention survey compared to the baseline survey. Baseline hypertension prevalence of 34.9% (CI 33.8-36.1) was reduced to 31.0% (CI 29.1-32.9) in the post intervention survey based on age adjusted analysis.
Our community based intervention using trained community based volunteers could increase awareness, treatment and control of hypertension among adult hypertensives.
在印度,基于社区的高血压干预措施极为有限。我们开展这项研究以探寻基于社区的干预项目对高血压知晓率、治疗率和控制率的效果。
通过整群抽样选取了4627名年龄≥30岁的成年人(男性占44%)进行基线调查。由经过培训的当地志愿者使用结构化访谈问卷收集信息。他们按照标准方案测量体重、身高、腰围和血压。志愿者每月至少监测一次血压,并在六年时间里就定期服药的必要性以及降低高血压危险因素对邻里群体进行健康教育。对2263名年龄≥30岁的成年人(男性占49%)进行了干预后调查。采用逐步逻辑回归分析来确定高血压知晓率、治疗率和控制率变化的比值比。
与基线调查相比,干预后调查中高血压的知晓率(比值比4.18,95%置信区间3.44 - 5.08)、治疗率(比值比3.44,置信区间2.81 - 4.22)和控制率(比值比4.39,置信区间3.36 - 5.73)显著提高。基于年龄调整分析,干预后调查中基线高血压患病率从34.9%(置信区间33.8 - 36.1)降至31.0%(置信区间29.1 - 32.9)。
我们利用经过培训的社区志愿者开展的基于社区的干预措施可提高成年高血压患者对高血压的知晓率、治疗率和控制率。