Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa
Abstract Background Low-and-middle income countries face a disproportionate burden of non-communicable diseases (NCDs) that threaten to overwhelm under-resourced health systems. Community health workers (CHWs) can promote NCD prevention, reach patients, and connect them to local community health res...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-17359-z |
| _version_ | 1797272882129141760 |
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| author | Lia K. McNulty Mark Stoutenberg Andrea Kolkenbeck-Ruh Amy Harrison Thabiso Mmoledi Daniel Katiyo Mimi Mhlaba Delisile Kubheka Lisa J. Ware |
| author_facet | Lia K. McNulty Mark Stoutenberg Andrea Kolkenbeck-Ruh Amy Harrison Thabiso Mmoledi Daniel Katiyo Mimi Mhlaba Delisile Kubheka Lisa J. Ware |
| author_sort | Lia K. McNulty |
| collection | DOAJ |
| description | Abstract Background Low-and-middle income countries face a disproportionate burden of non-communicable diseases (NCDs) that threaten to overwhelm under-resourced health systems. Community health workers (CHWs) can promote NCD prevention, reach patients, and connect them to local community health resources; however, little has been done to examine how referrals to these resources are utilized by community members. The purpose of this study is to examine the use of referrals to community-based health resources and investigate the factors influencing patient utilization of referrals connecting them to appropriate health resources for elevated blood pressure (BP). Methods CHWs conducted home visits, which included BP screening and brief counseling, with community members in Soweto, South Africa. Participants with elevated (systolic BP: 121–139/ diastolic BP: 81–89 mmHg) or high (≥ 140/90 mmHg) BP were referred to either a local, community-based physical activity (PA) program managed by a non-governmental organization or local health clinics. The number of participants that received and utilized their referrals was tracked. Follow-up interviews were conducted with individuals given a referral who: (1) went to the PA program, (2) did not go to the PA program, (3) went to a clinic, and (4) did not go to a clinic. Interviews were transcribed and analyzed to identify common themes and differences between groups regarding their decisions to utilize the referrals. Results CHWs visited 1056 homes, with 1001 community members consenting to the screening; 29.2% (n = 292) of adults were classified as having optimal BP (≤120/80 mmHg), 35.8% (n = 359) had elevated BP, and 35.0% (n = 350) had high BP. One hundred and seventy-three participants accepted a referral to the PA program with 46 (26.6%) enrolling. Five themes emerged from the interviews: (1) prior knowledge and thoughts on BP, (2) psychosocial factors associated with BP control, (3) perception about receiving the referral, (4) contextual factors influencing referral utilization, and (5) perceived benefits of utilizing the referral. Conclusion CHWs can successfully increase community members’ access to health resources by providing appropriate referrals. However, greater attention needs to address community members’ barriers and hesitancy to utilize health resources. |
| first_indexed | 2024-03-07T14:35:39Z |
| format | Article |
| id | doaj.art-2b208d78a34c4c1c9ec133008671f249 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-07T14:35:39Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-2b208d78a34c4c1c9ec133008671f2492024-03-05T20:37:46ZengBMCBMC Public Health1471-24582024-02-0124111410.1186/s12889-023-17359-zExamining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South AfricaLia K. McNulty0Mark Stoutenberg1Andrea Kolkenbeck-Ruh2Amy Harrison3Thabiso Mmoledi4Daniel Katiyo5Mimi Mhlaba6Delisile Kubheka7Lisa J. Ware8Department of Kinesiology, College of Public Health, Temple UniversityDepartment of Kinesiology, College of Public Health, Temple UniversityCardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the WitwatersrandSchool of Therapeutic Sciences, Faculty of Health Sciences, University of the WitwatersrandPhila Sonke Wellness InitiativeSA MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Chris Hani Baragwanath Academic HospitalSA MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Chris Hani Baragwanath Academic HospitalSA MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Chris Hani Baragwanath Academic HospitalSA MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Chris Hani Baragwanath Academic HospitalAbstract Background Low-and-middle income countries face a disproportionate burden of non-communicable diseases (NCDs) that threaten to overwhelm under-resourced health systems. Community health workers (CHWs) can promote NCD prevention, reach patients, and connect them to local community health resources; however, little has been done to examine how referrals to these resources are utilized by community members. The purpose of this study is to examine the use of referrals to community-based health resources and investigate the factors influencing patient utilization of referrals connecting them to appropriate health resources for elevated blood pressure (BP). Methods CHWs conducted home visits, which included BP screening and brief counseling, with community members in Soweto, South Africa. Participants with elevated (systolic BP: 121–139/ diastolic BP: 81–89 mmHg) or high (≥ 140/90 mmHg) BP were referred to either a local, community-based physical activity (PA) program managed by a non-governmental organization or local health clinics. The number of participants that received and utilized their referrals was tracked. Follow-up interviews were conducted with individuals given a referral who: (1) went to the PA program, (2) did not go to the PA program, (3) went to a clinic, and (4) did not go to a clinic. Interviews were transcribed and analyzed to identify common themes and differences between groups regarding their decisions to utilize the referrals. Results CHWs visited 1056 homes, with 1001 community members consenting to the screening; 29.2% (n = 292) of adults were classified as having optimal BP (≤120/80 mmHg), 35.8% (n = 359) had elevated BP, and 35.0% (n = 350) had high BP. One hundred and seventy-three participants accepted a referral to the PA program with 46 (26.6%) enrolling. Five themes emerged from the interviews: (1) prior knowledge and thoughts on BP, (2) psychosocial factors associated with BP control, (3) perception about receiving the referral, (4) contextual factors influencing referral utilization, and (5) perceived benefits of utilizing the referral. Conclusion CHWs can successfully increase community members’ access to health resources by providing appropriate referrals. However, greater attention needs to address community members’ barriers and hesitancy to utilize health resources.https://doi.org/10.1186/s12889-023-17359-zCommunity health workersHome visitHypertensionElevated blood pressureNon-communicable DiseasesPhysical activity |
| spellingShingle | Lia K. McNulty Mark Stoutenberg Andrea Kolkenbeck-Ruh Amy Harrison Thabiso Mmoledi Daniel Katiyo Mimi Mhlaba Delisile Kubheka Lisa J. Ware Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa BMC Public Health Community health workers Home visit Hypertension Elevated blood pressure Non-communicable Diseases Physical activity |
| title | Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa |
| title_full | Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa |
| title_fullStr | Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa |
| title_full_unstemmed | Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa |
| title_short | Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa |
| title_sort | examining the referral of patients with elevated blood pressure to health resources in an under resourced community in south africa |
| topic | Community health workers Home visit Hypertension Elevated blood pressure Non-communicable Diseases Physical activity |
| url | https://doi.org/10.1186/s12889-023-17359-z |
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