Katena Nyaradzai Arster, Shamu Shepherd, Fana Golden Tafadzwa, Rusakaniko Simbarashe
Family Medicine, Global and Public Health Unit, Department of Primary Health Care Sciences, University of Zimbabwe, Harare, Zimbabwe.
Internal Medicine Unit, Department of Primary Health Care Sciences, University of Zimbabwe, Harare, Zimbabwe.
JMIR Res Protoc. 2023 Oct 3;12:e47512. doi: 10.2196/47512.
Hypertension and diabetes are among the most common noncommunicable diseases in Zimbabwe. These 2 conditions are largely prevented and controlled by lifestyle modifications, such as healthy eating habits, physical activity, and avoiding the use of tobacco and alcohol.
This study aims to evaluate the effects of a community health worker (CHW)-led health literacy intervention on lifestyle modification among patients with diabetes and hypertension in the City of Harare, Zimbabwe, in terms of (1) adherence to recommended lifestyle changes, (2) blood pressure and blood glucose levels, and (3) medication adherence.
This is a 6-month-long cluster randomized controlled trial, which will be conducted in primary health care clinics in the city of Harare. A total of 14 clinics will be randomly allocated into either the intervention or control group. A total of 680 (49 participants per clinic) adult patients with hypertension and diabetes will be enrolled for the trial. Participants in the intervention arm will receive a simple health literacy intervention on lifestyle modification, which will be delivered by trained CHWs, while those in the control arm will receive usual care. The intervention consists of 4 face-to-face interactive educational sessions and monthly support visits by trained CHWs and will be carried out over a period of 6 months. The primary study outcomes will be blood pressure and blood glucose levels and levels of adherence to the recommended lifestyle modifications. Other outcomes will include adherence to medication. Data management and analysis will be done using Epi Info software, and the data will be analyzed using the intention-to-treat principle.
Recruitment of study participants commenced on June 1, 2023, and was completed on July 30, 2023. Baseline data are being collected after participants' recruitment, and the final data collection will be completed by January 31, 2024.
There is an information dearth regarding the effectiveness of CHW-led interventions for the management and control of hypertension in Zimbabwe. Our study offers an opportunity to show the effectiveness of CHWs in addressing the gaps in the management of hypertension and diabetes. The findings from our study will provide crucial evidence on the effectiveness and feasibility of a simple intervention delivered by CHWs in resource-constrained areas.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/47512.
高血压和糖尿病是津巴布韦最常见的非传染性疾病。这两种疾病在很大程度上可通过生活方式的改变来预防和控制，如健康的饮食习惯、体育活动以及避免使用烟草和酒精。
本研究旨在评估由社区卫生工作者（CHW）主导的健康素养干预对津巴布韦哈拉雷市糖尿病和高血压患者生活方式改变的影响，具体涉及（1）对推荐生活方式改变的依从性，（2）血压和血糖水平，以及（3）药物依从性。
这是一项为期6个月的整群随机对照试验，将在哈拉雷市的初级卫生保健诊所进行。总共14家诊所将被随机分配到干预组或对照组。共有680名（每家诊所49名参与者）患有高血压和糖尿病的成年患者将被纳入试验。干预组的参与者将接受由经过培训的社区卫生工作者提供的关于生活方式改变的简单健康素养干预，而对照组的参与者将接受常规护理。干预包括4次面对面的互动教育课程以及由经过培训的社区卫生工作者进行的每月一次的支持性家访，将在6个月的时间内进行。主要研究结果将是血压和血糖水平以及对推荐生活方式改变的依从程度。其他结果将包括药物依从性。数据管理和分析将使用Epi Info软件进行，数据将采用意向性分析原则进行分析。
研究参与者的招募于2023年6月1日开始，并于2023年7月30日完成。在参与者招募后正在收集基线数据，最终数据收集将于2024年1月31日前完成。
关于在津巴布韦由社区卫生工作者主导的干预措施对高血压管理和控制的有效性，存在信息匮乏的情况。我们的研究提供了一个机会来展示社区卫生工作者在解决高血压和糖尿病管理差距方面的有效性。我们研究的结果将为社区卫生工作者在资源受限地区提供的简单干预措施的有效性和可行性提供关键证据。国际注册报告识别号（IRRID）：PRR1 - 10.2196/47512。
