JMIR Publications

ABSTRACT

ABSTRACT 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. This six month long cluster-randomized controlled trial will be conducted in 14 primary health care clinics in the City of Harare. A total of 680 adult hypertension and diabetes patients will be enrolled for the trial. Participants in the intervention arm will receive a simple health literacy intervention on lifestyle modification (developed by the principal researcher), which will be delivered by trained community health worker, whilst those in the control arm will receive the usual care. Baseline and follow-up surveys will be conducted in a standardized manner in all the facilities. The primary study outcome will be levels of adherence to recommended lifestyle modification. Other outcomes will include changes in diabetes and hypertension control and adherence to medication, changes in glycosylated haemoglobin (HbA1c) measurements. Data management and analysis will be done using Epi-info software The use of community health workers to address the inadequate health care workers in management of hypertension, diabetes and other chronic conditions has been widely recommended for resource limited settings (Mishra et al., 2015; Joshi and Peiris, 2019). However, there is an information dearth regarding the effectiveness of community health worker interventions for management and control of hypertension in Ziombabwe. 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.