Acceptability and feasibility of home-based hypertension and physical activity screening by community health workers in an under-resourced community in South Africa

Stoutenberg, Mark; Crouch, Simone H.; McNulty, Lia K.; Kolkenbeck-Ruh, Andrea; Torres, Georgia; Gradidge, Philippe J. L.; Ly, Andy; Ware, Lisa J.

Abstract

Background
Low–middle-income countries (LMICs) face increasing burdens from non-communicable disease (NCDs) requiring primary care task shifting to community health workers (CHWs). This study explored community members' perceptions of NCD-focused, CHW-led home visits in a historically disadvantaged township of South Africa.

Methods
Trained CHWs visited community member homes, performing blood pressure and physical activity (PA) screenings, followed by brief counselling and a satisfaction survey. Semi-structured interviews were conducted within 3 days of the visit to learn about their experiences.

Results
CHWs visited 173 households, with 153 adult community members consenting to participate (88.4%). Participants reported that it was easy to understand CHW-delivered information (97%), their questions were answered well (100%), and they would request home service again (93%). Twenty-eight follow-up interviews revealed four main themes: 1) acceptance of CHW visits, 2) openness to counselling, 3) satisfaction with screening and a basic understanding of the results, and 4) receptiveness to the PA advice.

Conclusion
Community members viewed CHW-led home visits as an acceptable and feasible method for providing NCD-focused healthcare services in an under-resourced community. Expanding primary care reach through CHWs offers more accessible and individualized care, reducing barriers for individuals in under-resourced communities to access support for NCD risk reduction.

Citation

Stoutenberg, M., Crouch, S. H., McNulty, L. K., Kolkenbeck-Ruh, A., Torres, G., Gradidge, P. J. L., Ly, A., & Ware, L. J. (2023). Acceptability and feasibility of home-based hypertension and physical activity screening by community health workers in an under-resourced community in South Africa. Journal of Public Health, 32(6), 1011-1022. https://doi.org/10.1007/s10389-023-01873-w

• Journal Article Type: Article
• Acceptance Date: Feb 24, 2023
• Online Publication Date: Mar 23, 2023
• Publication Date: Mar 23, 2023
• Deposit Date: Jul 24, 2024
• Journal: Journal of Public Health
• Print ISSN: 0943-1853
• Electronic ISSN: 1613-2238
• Publisher: Springer
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 6
• Pages: 1011-1022
• DOI: https://doi.org/10.1007/s10389-023-01873-w
• Keywords: hypertension; non-communicable diseases; low-and-middle income countries; community health workers
• Public URL: https://durham-repository.worktribe.com/output/2611842
• Additional Information: Received: 30 December 2022; Accepted: 24 February 2023; First Online: 23 March 2023; : ; : Ethical approval was grant by the Human Research Ethics Committee (Medical) at the University of Witwatersrand [Ref. M200941 and M170334] for all study materials and procedures.; : All study participants provide written consent in electronic format before participating in any study activities.; : Not applicable.; : The authors have no relevant financial or non-financial interests to disclose.