International Centre for Mental Health Social Research, Department of Social Policy and Social Work, University of York, York YO10 5DD, UK.
Department of Neurology, St Vincent's Hospital Melbourne, VIC 3065, Australia.
Int J Environ Res Public Health. 2020 Nov 20;17(22):8636. doi: 10.3390/ijerph17228636.
In India, cardiovascular disease (CVD), with hypertension as its foremost risk factor, has the highest prevalence rate of non-communicable diseases (NCDs) and a rising mortality. Previous research has found a clustering of behavioural and social risks pertaining to NCDs, though the latter are infrequently addressed in public health interventions in India. This paper reaches toward the development of a social intervention to address social determinants of NCD relating to hypertension and diabetes. We used Theory of Change (ToC) as a theoretical approach to programme design. Mixed methods were used, including qualitative interviews with community members ( = 20), Accredited Social Health Activists ( = 6) and health professionals ( = 8), and a stakeholder workshop ( = 5 participants). The recruitment of participants from one local area in Kerala enabled us to map service provision and gain a holistic understanding of how to utilise the existing workforce to target social risk factors. The findings suggest that social interventions need to focus on ensuring health behaviour information reaches all parts of the community, and that those with more social risk factors are identified and supported to engage with treatment. Further research is required to test the resulting intervention model.
在印度，心血管疾病（CVD）是最主要的非传染性疾病（NCD）风险因素，其患病率最高，死亡率也在上升。先前的研究发现，与 NCD 相关的行为和社会风险因素存在聚集现象，但在印度的公共卫生干预措施中，这些风险因素很少得到解决。本文旨在制定一项社会干预措施，以解决与高血压和糖尿病相关的 NCD 的社会决定因素。我们使用变革理论（ToC）作为方案设计的理论方法。采用了混合方法，包括对社区成员（=20 人）、认证社会卫生活动家（=6 人）和卫生专业人员（=8 人）进行定性访谈，以及利益相关者研讨会（=5 名参与者）。在喀拉拉邦的一个地方招募参与者，使我们能够绘制服务提供图，并全面了解如何利用现有劳动力来针对社会风险因素。研究结果表明，社会干预措施需要重点确保健康行为信息覆盖社区的各个角落，并且要识别出具有更多社会风险因素的人，并支持他们参与治疗。需要进一步研究来测试由此产生的干预模型。
