JMIR Publications

ABSTRACT

Background:

Hypertension and diabetes are amongst the most common non-communicable diseases in Zimbabwe. These two conditions are largely prevented and controlled by modification of lifestyles such as healthy eating habits, physical activity as well as avoiding harmful use of tobacco and alcohol. We have designed a study to evaluate the effects of a community health worker-led health literacy intervention for lifestyle modification among diabetes and hypertension patients in Harare, Zimbabwe and this paper describes the research design and rationale.

Objective:

This study aims to evaluate the effects of a community health worker-led health literacy intervention for lifestyle modification on: (i) adherence to recommended lifestyle modification, (ii) blood pressure and blood glucose levels and (iii) adherence to medication.

Methods:

This is a six-month long cluster-randomized controlled trial, which will be conducted in primary health care clinics in the City of Harare. A total of 14 clinics will be randomly allocated into either the intervention or control group. A total of 680 ( 49 participants per clinic) adult patients with hypertension and diabetes will be enrolled for the trial Participants in the intervention arm will receive a simple health literacy intervention on lifestyle modification which will be delivered by trained community health workers, whilst those in the control arm will receive the usual care. The intervention consists of four face-to-face interactive educational sessions and monthly support visits by trained community health workers and will be conducted over a period of six months. The primary study outcomes will be blood pressure and blood glucose levels and levels of adherence to recommended lifestyle modification. Other outcomes will include adherence to medication. Data management and analysis will be done using Epi-info software and the data will be analysed using the intention to treat principle.

Results:

Recruitment of study participants commenced in June 2023 and is expected to be completed by 31 July 2023. Baseline data is being collected on recruitment of participants, whilst final data collection will be completed by 31 January 2024.

Conclusions:

There is an information dearth regarding the effectiveness of community health worker interventions for management and control of hypertension in Zimbabwe. Our study offers an opportunity to show the effectiveness of community health workers (CHWs) in addressing the gaps in management of hypertension and diabetes. The findings from our study will provide the much-needed evidence on the effectiveness and feasibility of a simple intervention delivered by CHWs in resource constrained areas.