TPS CVD Final Presentation
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Final presentation - CVD Team on July 21, 2011 on the Concluding Day of the Trans Disciplinary Problem Solving Course: co-taught by Washington University in St. Louis and ICTPH.
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TPS CVD Final Presentation
- 1. Addressing Hypertension in Rural India: Intervention Design, Implementation Strategies, and Evaluation Plan Nancy Mueller, Josh Yudkin, & Leslie Duling
- 2. Overview Disease Burden Hypertension Determinants Intervention and Implementation Evaluation
- 4. Shift in the burden of disease 80% of global CVD deaths occur in low and middle income countries1 By 2025, 1.56 billion people worldwide will be living with hypertension2 Estimated 20% hypertension prevalence rate in Tamil Nadu3
- 6. Weight (BMI and WC) Physical Activity Tobacco Use Alcohol Consumption Stress Diet
- 8. • Awareness and resource Population Level dissemination • Flipbook education, Personal/Familial maintenance efforts, and Level technology based activities • Technology services and Health Systems educational workshops at Level RMHC
- 10. Population Level Strategies *SHG CHW SHG members
- 11. Population Level Strategies SHG Education • Flipbook use • 2 group leads • Disseminate • Salt reduction materials among • Provided group members • Resources educational materials CHW *SHG Training dissemination
- 12. Population Level Strategies SHG Education • Flipbook use • 2 group leads • Disseminate • Salt reduction • Provided materials among • Resources group members educational materials CHW *SHG Training dissemination
- 13. Population Level Strategies SHG Education • Flipbook use • 2 group leads • Disseminate • Salt reduction • Provided materials among • Resources group members educational materials CHW *SHG Training dissemination
- 14. Household Level Strategies Flipbook education High blood pressure reading Invitation to workshop ≥140/90 Home-based Referred to hypertension RMHC screening by SVG Normal blood Follow up pressure reading annually
- 15. Health Systems Level Strategies • HMIS flagging Increased follow up • SVG home visit/call • SVG and RMHC based Education workshops • Salt reduction • SVG-household or RMHC level Overnight urine test • Baseline, mid-line, end line • HMIS IPD module Care continuum loop • Care center partnerships, PISP questions
- 16. Evaluation Plan: Formative, Process, and Evaluation
- 17. Formative Processes Informs: Program materials Intervention plans Strategies and activities Considers: Key stakeholders
- 18. Formative Evaluation Qualitative approaches Informal interviews Focus groups Quantitative approaches Cost evaluations Resource audits
- 19. Process Objectives Training the community health workers Ensure fidelity of program delivery Determining public penetration rate
- 20. Process Evaluation Qualitative methods KAP survey (training) ICTPH model of practical exams Focus groups CHW observations (delivery) Group lead observations Informal interview or survey (received)
- 21. Quantitative methods Educational session audit (delivery) Attendee assessment Follow up system audit (delivery/received)
- 22. Impact Objectives Increased awareness and knowledge Increased self efficacy Decreased sodium intake
- 23. Impact Evaluation Qualitative approaches Survey (KAP) Informal interview Quantitative Education activity and workshop audits Health metrics (urine test)
- 24. Multiple genetic and environmental factors Decreased Decreased Reduced risk sodium blood for CVD intake pressure Increased awareness, resources, and self efficacy
- 25. Acknowledgements ICTPH Staff Selva Swetha Sughavazhvu guides Karambayam residents
- 26. Contact Information Nancy Mueller BA, MPH candidate E: nancymueller@go.wustl.edu Leslie Duling BA, MPH/MSW candidate E: leslie.duling@go.wustl.edu Joshua Yudkin, BA/MPH candidate E: jsyudkin@wustl.edu Washington University in St. Louis
- 27. Thank you
- 28. References 1World Health Organization (2005). National Cardiovascular Disease Database. Retrieved from http://www.whoindia.org/LinkFiles/NMH_Resources_National_CVD_database- Final_Report.pdf 2Kearney, P.M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P.K., He, J. (2005). Global Burden of Hypertension: Analysis of Worldwide Data. Lancet: 365, 217-223. Retrieved from http://www.sld.cu/galerias/pdf/servicios/hta/global_burden_of_hypertension.pdf 3Mohan, V., Deepa, M., Farooq, S., Datta, M. and Deepa, R. (2007). Prevalence, Awareness, and Control of Hypertension in Chennai – The Chennai Urban Rural Epidemiology Study (CURES – 52). Journal of the Association of Physicians of India, 55(May).