Willis Andrew, Chatio Samuel, Darko Natalie, Nonterah Engelbert A, Zakariah-Akoto Sawudatu, Alale Joseph, Jones Ceri R, Curtis Ffion, Kunutsor Setor, Ansah Patrick O, Seidu Sam
School of Public Health, University College Cork, Cork, Ireland.
HRB Clinical Research Facility, University College 8 Cork, Cork, Ireland.
PLOS Glob Public Health. 2023 Oct 20;3(10):e0002201. doi: 10.1371/journal.pgph.0002201. eCollection 2023.
Prevalence of conditions which raise cardiovascular risk, such as hypertension and type 2 diabetes are seeing a dramatic rise in Sub Saharan Africa. A large proportion of these cases remain undiagnosed and there is limited resource to provide patients with self-management support and education once diagnosed. This study aimed to identify and catalogue community-based assets for the purposes of developing and deploying a screening and education programme for cardiometabolic risk factors (diabetes and hypertension) within religious organisations in a local community in a rural Ghanaian context. We utilised a community-based form of participatory research made up of a number of different components including community-based asset mapping and stakeholder consultation, supplemented by 18 in-depth interviews and 10 focus groups with n = 115 service users, to map existing assets with relevance to cardiometabolic health in this setting and context. Thematic analysis of interview and focus group data was performed to identify themes related to successful implementation of health screening. Two stakeholder workshops with local healthcare professionals, faith leaders and health policy makers were delivered to co-produced a prioritised list of recommendations and 'asset map' to aid deployment of mass screening within faith organisations in this context. The findings of this research highlight a number of 'hidden' community assets and motivational mechanisms at an individual, community and institutional levels; these have informed a list of recommendations which have been co-developed with the stakeholder group and local community to support the development of effective screening strategies for cardiometabolic conditions within faith organisations in this context. We have identified key mechanisms and assets which would support a sustainable screening approach designed to engage an underserved community at high CVD risk to promote general community health and well-being.
撒哈拉以南非洲地区，诸如高血压和2型糖尿病等会增加心血管疾病风险的病症患病率正在急剧上升。这些病例中有很大一部分仍未得到诊断，而且一旦确诊，为患者提供自我管理支持和教育的资源也很有限。本研究旨在识别并梳理基于社区的资产，以便在加纳农村地区的一个当地社区的宗教组织内，制定并开展一项针对心脏代谢风险因素（糖尿病和高血压）的筛查与教育计划。我们采用了一种基于社区的参与式研究形式，它由许多不同部分组成，包括基于社区的资产映射和利益相关者咨询，并辅以18次深度访谈以及与115名服务使用者进行的10次焦点小组访谈，以梳理在此环境和背景下与心脏代谢健康相关的现有资产。对访谈和焦点小组数据进行了主题分析，以确定与健康筛查成功实施相关的主题。举办了两次与当地医疗保健专业人员、宗教领袖和卫生政策制定者的利益相关者研讨会，共同制定了一份优先建议清单和“资产映射”，以协助在此背景下在宗教组织内开展大规模筛查。本研究结果凸显了个人、社区和机构层面的一些“隐藏”社区资产和激励机制；这些已形成了一份与利益相关者群体和当地社区共同制定的建议清单，以支持在此背景下宗教组织内针对心脏代谢疾病制定有效的筛查策略。我们已经确定了关键机制和资产，这些将支持一种可持续的筛查方法，旨在让一个心血管疾病高风险的服务不足社区参与进来，以促进社区整体健康和福祉。
