Singh A, Jenkins C, Calys-Tagoe B, Arulogun O S, Sarfo S, Ovbiagele B, Akpalu A, Melikam S, Uvere E, Owolabi M O
Department of Public Health, KNUST Hospital, Kumasi, Ghana.
J Community Med Health Educ. 2017 Apr;7(2). doi: 10.4172/2161-0711.1000518. Epub 2017 Apr 24.
Stroke is becoming a leading cause of disability and death, and a major public health concern in Sub-Saharan Africa (SSA). The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non-communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer high burdens of disease in SSA. This paper describes the process of SIREN project's community engagement activities in Ghana and Nigeria. The aims of community engagement (CE) within SIREN are to: i) elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA; ii) educate the community about stroke and ways to decrease disabilities and deaths from stroke; and iii) recruit 3000 control research subjects to participate in a case-control stroke study. CE focused on three-pronged activities-constitution and interaction with Community Advisory Board (CABs), Focus Group Discussions (n=27) and community education and outreach programs (n=88). FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Almost all indicated that genetic testing could help health provider's better treat stroke and help scientists better understand the causes of stroke. Over 7000 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. The CE core within SIREN is a first of its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high stroke risk populations.
中风正成为导致残疾和死亡的主要原因,也是撒哈拉以南非洲(SSA)地区主要的公共卫生问题。中风调查研究与教育网络(SIREN)旨在全面描述中风的基因组、社会文化、经济和行为风险因素,并组建有效的研究团队,以应对并减轻SSA地区中风和其他非传染性疾病的负担。实现这一目标的首要步骤之一是有效地让SSA地区那些疾病负担沉重的社区参与进来。本文描述了SIREN项目在加纳和尼日利亚开展社区参与活动的过程。SIREN项目中社区参与(CE)的目标是:i)从SSA地区有非洲血统的个体中,阐明关于中风及其风险因素的知识、态度、信念和行为(KABP)的信息;ii)向社区宣传中风以及减少中风导致的残疾和死亡的方法;iii)招募3000名对照研究对象参与一项中风病例对照研究。CE聚焦于三方面活动——组建社区咨询委员会(CABs)并与其互动、开展焦点小组讨论(共27次)以及社区教育和外展项目(共88次)。焦点小组讨论和外展项目表明,人们对中风以及风险因素和循证后续护理的了解有限,而且往往滞后。几乎所有人都表示基因检测有助于医疗服务提供者更好地治疗中风,并帮助科学家更好地了解中风的病因。在这些外展活动中,超过7000人接受了心血管风险因素方面的教育,约5000人接受了心血管风险因素筛查。SIREN项目中的CE核心是同类项目中首个评估并应对SSA地区患者、护理人员和地方领导人对中风及基因组学认知的公共外展参与举措,也可作为评估其他中风高风险人群的典范。