1. Towards the Development of an Intervention to Address Social Determinants of Non-Communicable Disease in Kerala, India: A Mixed Methods Study
- Author
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Jacques Joubert, Lorane Scaria, Lynette Joubert, Saju Madavanakadu Devassy, Anuja Maria Benny, Meredith Fendt-Newlin, and Martin Webber
- Subjects
hypertension ,Social Determinants of Health ,Health, Toxicology and Mutagenesis ,Psychological intervention ,India ,lcsh:Medicine ,Disease ,030204 cardiovascular system & hematology ,Article ,03 medical and health sciences ,Social support ,0302 clinical medicine ,cardiovascular disease ,Environmental health ,Diabetes Mellitus ,medicine ,Humans ,030212 general & internal medicine ,Social determinants of health ,Noncommunicable Diseases ,theory of change ,diabetes ,social risk ,lcsh:R ,Public Health, Environmental and Occupational Health ,Stakeholder ,Theory of change ,social support ,Non-communicable disease ,medicine.disease ,social intervention ,Workforce ,social capital - Abstract
In India, cardiovascular disease (CVD), with hypertension as its foremost risk factor, has the highest prevalence rate of non-communicable diseases (NCDs) and a rising mortality. Previous research has found a clustering of behavioural and social risks pertaining to NCDs, though the latter are infrequently addressed in public health interventions in India. This paper reaches toward the development of a social intervention to address social determinants of NCD relating to hypertension and diabetes. We used Theory of Change (ToC) as a theoretical approach to programme design. Mixed methods were used, including qualitative interviews with community members (n = 20), Accredited Social Health Activists (n = 6) and health professionals (n = 8), and a stakeholder workshop (n = 5 participants). The recruitment of participants from one local area in Kerala enabled us to map service provision and gain a holistic understanding of how to utilise the existing workforce to target social risk factors. The findings suggest that social interventions need to focus on ensuring health behaviour information reaches all parts of the community, and that those with more social risk factors are identified and supported to engage with treatment. Further research is required to test the resulting intervention model.
- Published
- 2020