Effectiveness of Female Community Health Volunteers Training on Hypertension Knowledge and Blood Pressure Measurement Skills in Nepal

Effectiveness of Female Community Health Volunteers Training Program on Hypertension Knowledge and Blood Pressure Measurement Skills in Kavrepalanchowk, Nepal

The investigators aimed to investigate the effectiveness of training FCHVs in hypertension knowledge and blood pressure measuring skills and explore their perceptions of challenges and opportunities to deliver hypertension counseling and monitor Blood pressure in the community. The investigators conducted a quasi-experimental study design among 131 FCHVs from Namobuddha and Mandandeupur municipalities. The investigators quantitatively measured the baseline and end-line hypertension knowledge and BP measurement skills after providing a one-day training on hypertension knowledge and BP measurement. Furthermore, the investigators conducted three focus group discussions with FCHVs to explore the challenges and opportunities of FCHVs in community-based hypertension management.

Study Overview

• Status: Completed
• Conditions: Female Community Health Volunteers
• Intervention / Treatment: Other: Training

Detailed Description

Female Community Health Volunteers (FCHVs) in Nepal could play a role in preventing and managing hypertension. Limited studies have been conducted on Nepal's FCHV knowledge and capacity to deliver hypertension-related counseling and services. The investigators investigate the effectiveness of training FCHVs in hypertension knowledge and blood pressure measuring skills and explore their perceptions of challenges and opportunities to deliver hypertension counseling and monitor Blood pressure in the community. The investigators conducted a quasi-experimental study design among 131 FCHVs from Namobuddha and Mandandeupur municipalities. The investigators quantitatively measured the baseline and end-line hypertension knowledge and BP measurement skills after providing a one-day training on hypertension knowledge and BP measurement. The investigators used the Hypertension Knowledge Level Scale (HK-LS) to assess the knowledge through face-to-face interviews and observed BP measurement skills using an observation checklist. The investigators used paired t-tests to see the mean difference before and after the training. The investigators performed linear regression to assess the hypertension knowledge and BP measurement skills scores with socio-demographic and FCHV's general performance. Furthermore, the investigators conducted three focus group discussions with FCHVs to explore the challenges and opportunities of FCHVs in community-based hypertension management. The investigators transcribed the recorded discussion verbatim and analyzed it using the framework analysis method

• Study Type: Interventional
• Enrollment (Actual): 131
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Nepal
  • Dhulikhel, Nepal
    • Prasansha Poudel

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Appointed as FCHV
• Age 18 years and older

Exclusion Criteria:

• Not able to respond during the data collection period
• Out of municipality during the data collection period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Other: Training to Female Community Health Volunteers; Female Community Health Volunteers received a one-day training on hypertension knowledge and blood pressure measurement skills. The training included sessions on hypertension knowledge and practical demonstrations of BP measurement techniques. The effectiveness of the training was assessed by measuring the baseline and end-line hypertension knowledge and BP measurement skills."

Other: Training; We conducted one day of training for FCHVs and four different groups of FCHVs from two municipalities. We conducted training on hypertension knowledge and blood pressure measurement skills for FCHVs. Studies from Nepal show that with appropriate training, FCHV has the potential to promote hypertension education and conduct hypertension screening. Access to essential equipment such as digital blood pressure monitors, would improve FCHV performance on measuring blood pressure. Therefore, our training was to provide hypertension knowledge and to train FCHVs to measure blood pressure. The training had two objectives referring to enhancing knowledge and building skills.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hypertension Knowledge	We measured the FCHVs Hypertension in terms of knowledge score The Hypertension Knowledge Level Scale (HK-LS) assessed respondents' knowledge in defining hypertension, lifestyle, medical treatment, drug compliance, diet, and complications of hypertension. Each item was a complete sentence that was either correct or incorrect. Each item was prepared as part of a standard answer (correct, incorrect, or do not know). The scale included 22 items divided into six subdimensions (annex - IV). Each correct answer is worth 1 point. The maximum score is 22 for the entire scale. The minimum score is zero for the whole scale, and a score of higher means better knowledge for all sub-dimensions.	Baseline and endline data collected within a single day. 1 day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Blood Pressure measurement skills	Blood pressure skills were observed in three pre- and post-observation segments using an observational checklist. At first, pre-observation was performed, and training to measure blood pressure was provided to FCHVs; after that, post-observation was performed. There were pre-measurement inquiries and instructions for five items, measurement instructions for items, and a post-measurement record of 1 item. We ticked "yes" or "no" if the FCHV performed the activity listed in the checklist. Each 'yes' item gets 1 point, and the total score ranges from 0 to 17, with higher scores indicating a higher skill level. We defined blood pressure measurement capacity as an indicator of the FCHVs could perform these four actions: Placement of measuring arm at the level of heart, Proper fastening of the cuff, Measuring blood pressure three times at 1 (or more) minute(s) intervals, Recording of all readings).	Baseline and endline data collected within a single day. 1 day

Collaborators and Investigators

• Sponsor: Kathmandu University School of Medical Sciences
• Investigators: Principal Investigator: Archana Shrestha, Kathmandu University School of Medical Sciences

Publications and helpful links

General Publications

• Tan J, Xu H, Fan Q, Neely O, Doma R, Gundi R, Shrestha B, Shrestha A, Shrestha S, Karmacharya B, Gu W, Ostbye T, Yan LL. Hypertension Care Coordination and Feasibility of Involving Female Community Health Volunteers in Hypertension Management in Kavre District, Nepal: A Qualitative Study. Glob Heart. 2020 Oct 23;15(1):73. doi: 10.5334/gh.872.
• Erkoc SB, Isikli B, Metintas S, Kalyoncu C. Hypertension Knowledge-Level Scale (HK-LS): a study on development, validity and reliability. Int J Environ Res Public Health. 2012 Mar;9(3):1018-29. doi: 10.3390/ijerph9031018. Epub 2012 Mar 22.

Study record dates

Study Major Dates

• Study Start (Actual): April 20, 2023
• Primary Completion (Actual): October 20, 2023
• Study Completion (Actual): June 1, 2024

Study Registration Dates

• First Submitted: July 23, 2024
• First Submitted That Met QC Criteria: July 28, 2024
• First Posted (Actual): July 31, 2024

Study Record Updates

• Last Update Posted (Actual): July 31, 2024
• Last Update Submitted That Met QC Criteria: July 28, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Training; Hypertension; Effectiveness; Knowledge; Blood Pressure Measurement Skills
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Hypertension
• Other Study ID Numbers: 36/24

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No