Online Program

Training and field work experiences of Community Health Workers conducting non-invasive, population-based screening for Cardiovascular Disease (CVD) in four communities in Low and Middle-Income Settings

Monday, November 2, 2015

Shafika Shafika Abrahams-Gessel1, SM, Center for Health Decision Science, Harvard School of Public Health, Boston
Thandi Rose Puoane, DrPH, School of Public Health, University of the Western Cape, Cape Town, South Africa
Catalina Denman, PhD, Centro de Estudios de Salud y Sociedad, El Colegio de Sonora, Hermosillo , Sonora, Mexico
Carlos Montano, PhD, Calzada Roosevelt 6-25 Zona 11, Institute of Nutrition of Central America and Panama (INCAP), Guatemala, Guatemala
Thomas Gaziano, MD, MSc, Division of Cardiovascular Medicine Brigham & Women’s Hospital, Boston
Diana Munguia Carrasco, MS, Health and Society Division, El Colegio de Sonora, Hermosillo, Mexico
Jabu Zulu, RN, University of the Western Cape, School of Public Health, Republic of South Africa, South Africa
Naomi Levitt, MD, Division of Endocrinology and Diabetes Department of Medicine, University of Cape Town, Cape Town, South Africa
Background: Effective task-sharing from physicians or nurses to Community Health Workers (CHWs) to conduct population-based screening for persons at risk for cardiovascular disease, has the potential to mitigate the impact CVD on vulnerable populations. CHWs in Bangladesh, Guatemala, Mexico, and South Africa were trained to conduct non-invasive population-based screening for persons at high risk for CVD

Objective (s): To assess the performance of CHWs during training and to describe their training and fieldwork experiences while conducting non-invasive screening for cardiovascular disease (CVD) risk in their communities

Methods: Written tests were used to assess CHWs’ acquisition of content knowledge during training and focus group discussions to capture their training and fieldwork experiences.

Findings: Training was effective at increasing the CHWs’ content knowledge of cardiovascular disease (CVD) and this knowledge was largely retained up to six months after the completion of field work.  Common themes that need to be addressed when designing task sharing with CHWs in chronic diseases were identified, including language, respect, and compensation. The importance of having intimate knowledge of the community receiving services, from the design to implementation phases, is underscored.

Conclusions: Effective training for screening for CVD in community settings should have a strong didactic core that is supplemented with culture-specific adaptations in the delivery of instruction. The incorporation of expert and intimate knowledge of the communities themselves is critical, from the design to implementation phases of training. Challenges such as role definition, defining career paths, and providing adequate remuneration, must be addressed.

Learning Areas:

Chronic disease management and prevention
Other professions or practice related to public health

Learning Objectives:
Demonstrate that community health workers can be trained in conducting non-invasive, population-based screening for Cardiovascular Disease

Keyword(s): Chronic Disease Prevention, Community Health Workers and Promoters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-investigator in this project and participated in the conceptualization, data collection, analysis and writing up of the manuscript
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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