Effectiveness of a community-based education and peer support led by women’s self-help groups in improving the control of hypertension in urban slums of Kerala, India: a cluster randomised controlled pragmatic trial
Background With less than 20% of people with hypertension achieving their target blood pressure (BP) goals, uncontrolled hypertension remains a major public health problem in India. We conducted a study to assess the effectiveness of a community-based education and peer support programme led by wome...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/7/11/e010296.full |
| _version_ | 1797984163512451072 |
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| author | Rajani Ved Goodarz Danaei Donna Spiegelman Jaideep C Menon Rakesh P Suseela Renjini Balakrishnan Ambika Sreelakshmi Mohandas Mathews Numpelil Beena K Vasudevan |
| author_facet | Rajani Ved Goodarz Danaei Donna Spiegelman Jaideep C Menon Rakesh P Suseela Renjini Balakrishnan Ambika Sreelakshmi Mohandas Mathews Numpelil Beena K Vasudevan |
| author_sort | Rajani Ved |
| collection | DOAJ |
| description | Background With less than 20% of people with hypertension achieving their target blood pressure (BP) goals, uncontrolled hypertension remains a major public health problem in India. We conducted a study to assess the effectiveness of a community-based education and peer support programme led by women’s self-help group (SHG) members in reducing the mean systolic BP among people with hypertension in urban slums of Kochi city, Kerala, India.Methods A cluster randomised controlled pragmatic trial was conducted where 20 slums were randomised to either the intervention or the control arms. In each slum, participants who had elevated BP (>140/90) or were on antihypertensive medications were recruited. The intervention was delivered through women’s SHG members (1 per 20–30 households) who provided (1) assistance in daily hypertension management, (2) social and emotional support to encourage healthy behaviours and (3) referral to the primary healthcare system. Those in the control arm received standard of care. The primary outcome was change in mean systolic BP (SBP) after 6 months.Results A total of 1952 participants were recruited—968 in the intervention arm and 984 in the control arm. Mean SBP was reduced by 6.26 mm Hg (SE 0.69) in the intervention arm compared with 2.16 mm Hg (SE 0.70) in the control arm; the net difference being 4.09 (95% CI 2.15 to 4.09), p<0.001.Conclusion This women’s SHG members led community intervention was effective in reducing SBP among people with hypertension compared with those who received usual care, over 6 months in urban slums of Kerala, India.Trial registration number CTRI/2019/12/022252. |
| first_indexed | 2024-04-11T06:58:17Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2059-7908 |
| language | English |
| last_indexed | 2024-04-11T06:58:17Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj.art-d5784d7a9ccd4ba093bd399a9e29e8b82022-12-22T04:38:57ZengBMJ Publishing GroupBMJ Global Health2059-79082022-11-0171110.1136/bmjgh-2022-010296Effectiveness of a community-based education and peer support led by women’s self-help groups in improving the control of hypertension in urban slums of Kerala, India: a cluster randomised controlled pragmatic trialRajani Ved0Goodarz Danaei1Donna Spiegelman2Jaideep C Menon3Rakesh P Suseela4Renjini Balakrishnan Ambika5Sreelakshmi Mohandas6Mathews Numpelil7Beena K Vasudevan8National Health Systems Resource Centre, New Delhi, Delhi, IndiaGlobal Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USADepartment of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USACardiology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, IndiaDepartment of Community Medicine & Center for Public Health, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, IndiaDepartment of Community Medicine & Center for Public Health, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, IndiaDepartment of Community Medicine & Center for Public Health, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, IndiaNational Health Mission, Kochi, Kerala, IndiaDepartment of Community Medicine & Center for Public Health, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, IndiaBackground With less than 20% of people with hypertension achieving their target blood pressure (BP) goals, uncontrolled hypertension remains a major public health problem in India. We conducted a study to assess the effectiveness of a community-based education and peer support programme led by women’s self-help group (SHG) members in reducing the mean systolic BP among people with hypertension in urban slums of Kochi city, Kerala, India.Methods A cluster randomised controlled pragmatic trial was conducted where 20 slums were randomised to either the intervention or the control arms. In each slum, participants who had elevated BP (>140/90) or were on antihypertensive medications were recruited. The intervention was delivered through women’s SHG members (1 per 20–30 households) who provided (1) assistance in daily hypertension management, (2) social and emotional support to encourage healthy behaviours and (3) referral to the primary healthcare system. Those in the control arm received standard of care. The primary outcome was change in mean systolic BP (SBP) after 6 months.Results A total of 1952 participants were recruited—968 in the intervention arm and 984 in the control arm. Mean SBP was reduced by 6.26 mm Hg (SE 0.69) in the intervention arm compared with 2.16 mm Hg (SE 0.70) in the control arm; the net difference being 4.09 (95% CI 2.15 to 4.09), p<0.001.Conclusion This women’s SHG members led community intervention was effective in reducing SBP among people with hypertension compared with those who received usual care, over 6 months in urban slums of Kerala, India.Trial registration number CTRI/2019/12/022252.https://gh.bmj.com/content/7/11/e010296.full |
| spellingShingle | Rajani Ved Goodarz Danaei Donna Spiegelman Jaideep C Menon Rakesh P Suseela Renjini Balakrishnan Ambika Sreelakshmi Mohandas Mathews Numpelil Beena K Vasudevan Effectiveness of a community-based education and peer support led by women’s self-help groups in improving the control of hypertension in urban slums of Kerala, India: a cluster randomised controlled pragmatic trial BMJ Global Health |
| title | Effectiveness of a community-based education and peer support led by women’s self-help groups in improving the control of hypertension in urban slums of Kerala, India: a cluster randomised controlled pragmatic trial |
| title_full | Effectiveness of a community-based education and peer support led by women’s self-help groups in improving the control of hypertension in urban slums of Kerala, India: a cluster randomised controlled pragmatic trial |
| title_fullStr | Effectiveness of a community-based education and peer support led by women’s self-help groups in improving the control of hypertension in urban slums of Kerala, India: a cluster randomised controlled pragmatic trial |
| title_full_unstemmed | Effectiveness of a community-based education and peer support led by women’s self-help groups in improving the control of hypertension in urban slums of Kerala, India: a cluster randomised controlled pragmatic trial |
| title_short | Effectiveness of a community-based education and peer support led by women’s self-help groups in improving the control of hypertension in urban slums of Kerala, India: a cluster randomised controlled pragmatic trial |
| title_sort | effectiveness of a community based education and peer support led by women s self help groups in improving the control of hypertension in urban slums of kerala india a cluster randomised controlled pragmatic trial |
| url | https://gh.bmj.com/content/7/11/e010296.full |
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