Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban.
S Afr Fam Pract (2004). 2020 Jul 16;62(1):e1-e14. doi: 10.4102/safp.v62i1.5039.
Hypertension (HT) is a key contributor to cardiovascular diseases (CVDs). The improved management of HT in the community and primary care settings should be a priority for low- and middle-income countries (LMICs). Improving the prevention and management of HT in primary care settings should also be a priority for developing countries. There is a need for more studies using community-based approaches that show the impact of these programmes on HT outcomes, which may motivate policymakers to invest in such approaches. The ward-based outreach team or village healthcare worker models were meant to provide such approaches, but many of these have become lower levels of curative care. We conducted a scoping review to examine how community-based participatory research (CBPR) was being used to improve HT management.
Several electronic databases were searched, namely PubMed, MEDLINE, Google Scholar and Web of Science, generating 798 references. The publications were screened through several rounds. Data were extracted and imported into a Microsoft Excel spreadsheet, numerically summarised and qualitatively analysed.
Nine articles were included. These publications originated from the United States, Colombia, Canada, China, South Africa and Zimbabwe. Mixed methods, qualitative, randomised control trials and quasi-experimental studies were used to implement CBPR in the studies included. All the studies addressed complex health problems and inequities among the minorities utilising multiple stakeholder participation. Academic-community coalitions were formed, which enabled engagement and sharing of power equitably. As a result, there was acceptability and sustainability of interventions.
A CBPR framework can be used to define the context, group dynamics, implementation and outcomes of HT. It is possible to apply CBPR in HT management to appropriately address health disparities while emphasising a community-driven approach. To achieve this, tailored health education platforms should be developed and implemented.
高血压（HT）是心血管疾病（CVDs）的主要致病因素。改善社区和初级保健环境中 HT 的管理应成为中低收入国家（LMICs）的优先事项。在发展中国家，也应优先考虑改善初级保健环境中 HT 的预防和管理。需要进行更多使用基于社区的方法的研究，以展示这些方案对 HT 结果的影响，这可能促使政策制定者投资于此类方法。基于病房的外展团队或乡村医疗工作者模式旨在提供此类方法，但其中许多已成为较低层次的治疗保健。我们进行了范围审查，以研究基于社区的参与式研究（CBPR）如何用于改善 HT 管理。
我们搜索了几个电子数据库，包括 PubMed、MEDLINE、Google Scholar 和 Web of Science，共生成了 798 条参考文献。通过几轮筛选对出版物进行了筛选。提取数据并导入 Microsoft Excel 电子表格中，进行数值总结和定性分析。
共纳入 9 篇文章。这些出版物来自美国、哥伦比亚、加拿大、中国、南非和津巴布韦。纳入研究中使用混合方法、定性、随机对照试验和准实验研究来实施 CBPR。所有研究都针对少数群体中的复杂健康问题和不平等问题，利用多方利益相关者的参与。形成了学术-社区联盟，从而实现了公平的参与和权力共享。因此，干预措施具有可接受性和可持续性。
CBPR 框架可用于定义 HT 的背景、群体动态、实施和结果。可以在 HT 管理中应用 CBPR，以适当解决健康差距问题，同时强调社区驱动的方法。为此，应开发和实施定制的健康教育平台。
