School of Medicine, Lung Institute, Makerere University College of Health Sciences, Upper Hill Mulago Hill, Kampala, Uganda.
Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
BMC Public Health. 2021 Jul 7;21(1):1343. doi: 10.1186/s12889-021-11411-6.
The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda.
We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon's model of acceptability of health Interventions to explore participants' perceptions.
Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material (PocketDoktor™) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor™, financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting.
Hypertension patient-centered education delivered by CHWs using the PocketDoktor™ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.
在低收入和中等收入国家（LMICs），艾滋病毒/艾滋病感染者（PLWHA）的高血压患病率正在上升。然而，乌干达 PLWHA 对高血压并发症和管理的了解仍然很低。我们探讨了在乌干达农村地区由社区卫生工作者（CHWs）实施针对高血压（HTN）的具体健康教育在 PLWHA 中的可接受性。
我们进行了一项定性研究，包括 22 次深入访谈（14 名 PLWHA/HTN 和 8 名 CHWs）、3 次焦点小组讨论（2 次与 PLWHA/HTN 进行，1 次与 CHWs 进行），来自乌干达 Nakaseke 区。参与者在与 CHW 进行一次单一会议互动后接受了采访。数据从卢干达语（当地语言）转录为英语，并使用主题分析进行分析。我们使用 Sekhon 的健康干预措施可接受性模型来探讨参与者的看法。
参与者认为 CHWs 在教育提供过程中使用了易于理解的、口语化的、非技术性的语言，与 CHWs 之间已经建立了预先存在的融洽关系，这有助于更快的沟通，并且有更多的时间来解释疾病，而不是医生有。参与者发现教育材料（PocketDoktor™）简单易懂，并认为该教育将导致改善健康结果。参与者表示他们的健康是重中之重，并寻求进一步的疾病特定信息。我们还发现，CHWs 非常有动力开展以患者为中心的教育。在提供教育的过程中，CHWs 在 PocketDoktor™ 中关于高血压的技术细节方面遇到了困难，经济压力以及超出他们自我认为的技能水平和经验的患者问题。PLWHA/HTN 在获得干预措施提供的卫生设施方面存在困难，他们更喜欢家庭环境。
使用 PocketDoktor™ 由 CHWs 提供的以高血压患者为中心的教育在 Nakaseke 地区的 PLWHA 和高血压患者中是可以接受的。需要进一步的研究来确定在 LMIC 环境中为 PLWHA 提供这种干预措施的成本影响。
