Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study
Background: A combination of increasing urbanization, behaviour change, and lack of health services in slums put the urban poor specifically at risk of cardiovascular disease (CVD). This study aimed to evaluate the impact of a community-based CVD prevention intervention on blood pressure (BP) and ot...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2016-03-01
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| Series: | Global Health Action |
| Subjects: | |
| Online Access: | http://www.globalhealthaction.net/index.php/gha/article/view/30922/pdf_214 |
| _version_ | 1828515009448116224 |
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| author | Steven van de Vijver Samuel Oji Oti Gabriela B. Gomez Charles Agyemang Thaddaeus Egondi Eric Moll van Charante Lizzy M. Brewster Catherine Hankins Zlata Tanovic Alex Ezeh Catherine Kyobutungi Karien Stronks |
| author_facet | Steven van de Vijver Samuel Oji Oti Gabriela B. Gomez Charles Agyemang Thaddaeus Egondi Eric Moll van Charante Lizzy M. Brewster Catherine Hankins Zlata Tanovic Alex Ezeh Catherine Kyobutungi Karien Stronks |
| author_sort | Steven van de Vijver |
| collection | DOAJ |
| description | Background: A combination of increasing urbanization, behaviour change, and lack of health services in slums put the urban poor specifically at risk of cardiovascular disease (CVD). This study aimed to evaluate the impact of a community-based CVD prevention intervention on blood pressure (BP) and other CVD risk factors in a slum setting in Nairobi, Kenya. Design: Prospective intervention study includes awareness campaigns, household visits for screening, and referral and treatment of people with hypertension. The primary outcome was overall change in mean systolic blood pressure (SBP), while secondary outcomes were changes in awareness of hypertension and other CVD risk factors. We evaluated the intervention's impact through consecutive cross-sectional surveys at baseline and after 18 months, comparing outcomes of intervention and control group, through a difference-in-difference method. Results: We screened 1,531 and 1,233 participants in the intervention and control sites. We observed a significant reduction in mean SBP when comparing before and after measurements in both intervention and control groups, −2.75 mmHg (95% CI −4.33 to −1.18, p=0.001) and −1.67 mmHg (95% CI −3.17 to −0.17, p=0.029), respectively. Among people with hypertension at baseline, SBP was reduced by −14.82 mmHg (95% CI −18.04 to −11.61, p<0.001) in the intervention and −14.05 (95% CI −17.71 to −10.38, p<0.001) at the control site. However, comparing these two groups, we found no difference in changes in mean SBP or hypertension prevalence. Conclusions: We found significant declines in SBP over time in both intervention and control groups. However, we found no additional effect of a community-based intervention involving awareness campaigns, screening, referral, and treatment. Possible explanations include the beneficial effect of baseline measurements in the control group on behaviour and related BP levels, and the limited success of treatment and suboptimal adherence in the intervention group. |
| first_indexed | 2024-12-11T18:07:31Z |
| format | Article |
| id | doaj.art-dd63f40eb3bc4c7ca67e7e366449dac0 |
| institution | Directory Open Access Journal |
| issn | 1654-9880 |
| language | English |
| last_indexed | 2024-12-11T18:07:31Z |
| publishDate | 2016-03-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-dd63f40eb3bc4c7ca67e7e366449dac02022-12-22T00:55:41ZengTaylor & Francis GroupGlobal Health Action1654-98802016-03-019011010.3402/gha.v9.3092230922Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP studySteven van de Vijver0Samuel Oji Oti1Gabriela B. Gomez2Charles Agyemang3Thaddaeus Egondi4Eric Moll van Charante5Lizzy M. Brewster6Catherine Hankins7Zlata Tanovic8Alex Ezeh9Catherine Kyobutungi10Karien Stronks11 African Population and Health Research Center, Nairobi, Kenya African Population and Health Research Center, Nairobi, Kenya Department of Global Health, Academic Medical Center, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands African Population and Health Research Center, Nairobi, Kenya Department of Family Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Global Health, Academic Medical Center, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands Amsterdam Institute for International Development (AIID), Faculty of Economics and Business Administration, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands African Population and Health Research Center, Nairobi, Kenya African Population and Health Research Center, Nairobi, Kenya Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsBackground: A combination of increasing urbanization, behaviour change, and lack of health services in slums put the urban poor specifically at risk of cardiovascular disease (CVD). This study aimed to evaluate the impact of a community-based CVD prevention intervention on blood pressure (BP) and other CVD risk factors in a slum setting in Nairobi, Kenya. Design: Prospective intervention study includes awareness campaigns, household visits for screening, and referral and treatment of people with hypertension. The primary outcome was overall change in mean systolic blood pressure (SBP), while secondary outcomes were changes in awareness of hypertension and other CVD risk factors. We evaluated the intervention's impact through consecutive cross-sectional surveys at baseline and after 18 months, comparing outcomes of intervention and control group, through a difference-in-difference method. Results: We screened 1,531 and 1,233 participants in the intervention and control sites. We observed a significant reduction in mean SBP when comparing before and after measurements in both intervention and control groups, −2.75 mmHg (95% CI −4.33 to −1.18, p=0.001) and −1.67 mmHg (95% CI −3.17 to −0.17, p=0.029), respectively. Among people with hypertension at baseline, SBP was reduced by −14.82 mmHg (95% CI −18.04 to −11.61, p<0.001) in the intervention and −14.05 (95% CI −17.71 to −10.38, p<0.001) at the control site. However, comparing these two groups, we found no difference in changes in mean SBP or hypertension prevalence. Conclusions: We found significant declines in SBP over time in both intervention and control groups. However, we found no additional effect of a community-based intervention involving awareness campaigns, screening, referral, and treatment. Possible explanations include the beneficial effect of baseline measurements in the control group on behaviour and related BP levels, and the limited success of treatment and suboptimal adherence in the intervention group.http://www.globalhealthaction.net/index.php/gha/article/view/30922/pdf_214cardiovascular diseasepreventionawarenesstreatmenthypertensionblood pressureslumurban poorKenya |
| spellingShingle | Steven van de Vijver Samuel Oji Oti Gabriela B. Gomez Charles Agyemang Thaddaeus Egondi Eric Moll van Charante Lizzy M. Brewster Catherine Hankins Zlata Tanovic Alex Ezeh Catherine Kyobutungi Karien Stronks Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study Global Health Action cardiovascular disease prevention awareness treatment hypertension blood pressure slum urban poor Kenya |
| title | Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study |
| title_full | Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study |
| title_fullStr | Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study |
| title_full_unstemmed | Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study |
| title_short | Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study |
| title_sort | impact evaluation of a community based intervention for prevention of cardiovascular diseases in the slums of nairobi the scale up study |
| topic | cardiovascular disease prevention awareness treatment hypertension blood pressure slum urban poor Kenya |
| url | http://www.globalhealthaction.net/index.php/gha/article/view/30922/pdf_214 |
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