Khetan Aditya, Patel Toral, Hejjaji Vittal, Barbhaya Dweep, Mohan Sri Krishna Madan, Josephson Richard, Webel Allison
Harrington Heart and Vascular Institute, University Hospitals Health System, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, United States.
Department of Medicine, University Hospitals Health System, Case Western Reserve University School of Medicine, Cleveland, OH, United States.
Eval Program Plann. 2018 Apr;67:177-183. doi: 10.1016/j.evalprogplan.2018.01.006. Epub 2018 Jan 17.
Cardiovascular disease (CVD) is the leading cause of mortality in India. Since community health workers (CHWs) have historically played a pivotal role in improving maternal and child health, it has been hypothesized that they have the potential to mitigate the impact of CVD in countries such as India. Project SEHAT is a cluster RCT to test the hypothesis that CHWs can improve the control of cardiovascular risk factors in a community in West Bengal, India. This study sought to quantitatively assess the training outcomes of CHWs recruited for Project SEHAT, and qualitatively assess their recruitment, training and fieldwork experiences. CHWs were recruited through a 2 step process- a written test and an interview. Upon completion of training, their knowledge and experiences were assessed. All intervention CHWs scored > 80% on the knowledge test, implying a high rate of knowledge retention. Important themes identified during a focus group discussion with CHWs included satisfaction with a 2 step recruitment process, emphasis on communication skills, a preference for audio-visual aids in training and recognition of the importance of a supportive supervisory framework. Respect from society and a positive impact on people was consistently cited as the most satisfying aspects of the job, followed by financial compensation. Recruitment and training processes for CHWs in CVD programs should be more standardized to enable replication, scalability and adequate assessment of their potential to mitigate CVD mortality in countries such as India.
心血管疾病（CVD）是印度的主要死因。由于社区卫生工作者（CHWs）在历史上对改善孕产妇和儿童健康发挥了关键作用，因此有人推测他们有潜力减轻印度等国家心血管疾病的影响。SEHAT项目是一项整群随机对照试验，旨在检验社区卫生工作者能否改善印度西孟加拉邦一个社区心血管危险因素控制情况的假设。本研究旨在定量评估为SEHAT项目招募的社区卫生工作者的培训成果，并定性评估他们的招募、培训和实地工作经历。社区卫生工作者通过两步流程招募——笔试和面试。培训结束后，对他们的知识和经验进行评估。所有干预组的社区卫生工作者在知识测试中得分均>80%，这意味着知识保留率很高。在与社区卫生工作者进行焦点小组讨论时确定的重要主题包括对两步招募流程的满意度、对沟通技巧的重视、在培训中对视听辅助工具的偏好以及认识到支持性监督框架的重要性。来自社会的尊重和对人们产生的积极影响一直被认为是工作中最令人满意的方面，其次是经济补偿。心血管疾病项目中社区卫生工作者的招募和培训流程应更加标准化，以便在印度等国家能够复制、扩大规模并充分评估其减轻心血管疾病死亡率的潜力。
