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Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study

Global health action, 2016-01, Vol.9 (1), p.30922-30922 [Peer Reviewed Journal]

2016 Steven van de Vijver et al. 2016 ;Copyright Co-Action Publishing 2016 ;2016 Steven van de Vijver et al. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;ISSN: 1654-9716 ;EISSN: 1654-9880 ;DOI: 10.3402/gha.v9.30922 ;PMID: 27019347

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Title:
Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study
Author: van de Vijver, Steven ; Oti, Samuel Oji ; Gomez, Gabriela B. ; Agyemang, Charles ; Egondi, Thaddaeus ; van Charante, Eric Moll ; Brewster, Lizzy M. ; Hankins, Catherine ; Tanovic, Zlata ; Ezeh, Alex ; Kyobutungi, Catherine ; Stronks, Karien
Subjects: Adult ; Alcohol ; awareness ; Behavior ; Behavioural changes ; Blood pressure ; Blood Pressure Determination ; Campaigns ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - prevention & control ; Central business districts ; Change agents ; Clinical assessment ; Control groups ; Cross-Sectional Studies ; Disease prevention ; Female ; Funding ; Gender differences ; Ghettos ; Health facilities ; Health insurance ; Health Promotion - methods ; Health services ; Humans ; Hypertension ; Hypertension - epidemiology ; Hypertension - prevention & control ; Intervention ; Kenya ; Kenya - epidemiology ; Low income groups ; Male ; Medical research ; Medical screening ; Middle Aged ; Mortality ; Original ; Population ; Poverty Areas ; Prevalence ; prevention ; Prevention programs ; Prospective Studies ; Public health ; Risk Factors ; Risk perception ; slum ; Slums ; Studies ; treatment ; Urban areas ; urban poor ; Urbanization
Is Part Of: Global health action, 2016-01, Vol.9 (1), p.30922-30922
Description: 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. 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. 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. 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.
Publisher: United States: Taylor & Francis
Language: English
Identifier: ISSN: 1654-9716
EISSN: 1654-9880
DOI: 10.3402/gha.v9.30922
PMID: 27019347
Source: Taylor & Francis OA刊
PubMed Central (Open access)
DOAJ Directory of Open Access Journals
Geneva Foundation Free Medical Journals at publisher websites
AUTh Library subscriptions: ProQuest Central
ROAD
MEDLINE
Co Action Journals (Open access)

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Impact evaluation of a community-based intervention for prevention of cardiovascular diseases in the slums of Nairobi: the SCALE-UP study

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