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Multicomponent Short-Term Training of ASHAs for Stroke Risk Factor Management in Rural India

Background Stroke is one of the leading causes of disability-adjusted life years and may be the leading cause of death in rural regions in India. We aim to train the ASHAs (Accredited Social Health activist) for nonpharmacological management of risk factors for secondary stroke prevention in rural I...

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Autores principales: Jain, Maneeta, Pandian, Jeyaraj, Samuel, Clarence, Singh, Shavinder, Kamra, Deepshikha, Kate, Mahesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers 2019
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908455/
https://www.ncbi.nlm.nih.gov/pubmed/31844374
http://dx.doi.org/10.1055/s-0039-3399396
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author Jain, Maneeta
Pandian, Jeyaraj
Samuel, Clarence
Singh, Shavinder
Kamra, Deepshikha
Kate, Mahesh
author_facet Jain, Maneeta
Pandian, Jeyaraj
Samuel, Clarence
Singh, Shavinder
Kamra, Deepshikha
Kate, Mahesh
author_sort Jain, Maneeta
collection PubMed
description Background Stroke is one of the leading causes of disability-adjusted life years and may be the leading cause of death in rural regions in India. We aim to train the ASHAs (Accredited Social Health activist) for nonpharmacological management of risk factors for secondary stroke prevention in rural India. We tested the hypothesis that focused, multicomponent, short-term training on secondary prevention of stroke enhances the knowledge of ASHAs about risk factor management. Objectives To test the hypothesis that focused, multicomponent, short-term training on secondary prevention of stroke enhances the knowledge of ASHAs about risk factor management. Materials and Methods This study is part of the ASSIST trial (Training ASHA to Assist in Secondary Stroke Prevention in Rural Population). The study design is quasi-experimental (pretest and posttest). Culturally appropriate and pragmatic training material was developed by the study team. Three focused group training sessions were conducted in Sidhwan Bet and Pakhowal blocks of Ludhiana district, Punjab. Results A total of 274 ASHAs from 164 villages with mean ± SD age of 39.5 ± 7.6 years participated in the three training sessions. The perceived knowledge of stroke risk factors and blood pressure assessment was 67.5 ± 18.3% and 84.4 ± 16.7%, respectively. The objective baseline knowledge about stroke prevention and management among ASHAs was lower 58.7 ± 19.7% compared with perceived knowledge ( p = 0.04). This increased to 82.5 ± 16.36% ( p < 0.001) after the mop-up training after a mean of 191 days. More than 30% increment was seen in knowledge about the stroke symptoms (35.9%, p < 0.001), avoiding opium after stroke for treatment (39.5%, p < 0.001), causes of stroke (53.3%, p < 0.001), modifiable risk factors for stroke (45.4%, p < 0.001), and lifestyle modifications for stroke prevention (42.1%, p < 0.001). Conclusions Focused group training can help enhance the knowledge of ASHAs about stroke prevention and management. ASHAs are also able to retain this complex multicomponent knowledge over a 6-month period. ASHA may be able to partake in reducing the secondary stroke burden in rural India.
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spelling pubmed-69084552019-12-16 Multicomponent Short-Term Training of ASHAs for Stroke Risk Factor Management in Rural India Jain, Maneeta Pandian, Jeyaraj Samuel, Clarence Singh, Shavinder Kamra, Deepshikha Kate, Mahesh J Neurosci Rural Pract Background Stroke is one of the leading causes of disability-adjusted life years and may be the leading cause of death in rural regions in India. We aim to train the ASHAs (Accredited Social Health activist) for nonpharmacological management of risk factors for secondary stroke prevention in rural India. We tested the hypothesis that focused, multicomponent, short-term training on secondary prevention of stroke enhances the knowledge of ASHAs about risk factor management. Objectives To test the hypothesis that focused, multicomponent, short-term training on secondary prevention of stroke enhances the knowledge of ASHAs about risk factor management. Materials and Methods This study is part of the ASSIST trial (Training ASHA to Assist in Secondary Stroke Prevention in Rural Population). The study design is quasi-experimental (pretest and posttest). Culturally appropriate and pragmatic training material was developed by the study team. Three focused group training sessions were conducted in Sidhwan Bet and Pakhowal blocks of Ludhiana district, Punjab. Results A total of 274 ASHAs from 164 villages with mean ± SD age of 39.5 ± 7.6 years participated in the three training sessions. The perceived knowledge of stroke risk factors and blood pressure assessment was 67.5 ± 18.3% and 84.4 ± 16.7%, respectively. The objective baseline knowledge about stroke prevention and management among ASHAs was lower 58.7 ± 19.7% compared with perceived knowledge ( p = 0.04). This increased to 82.5 ± 16.36% ( p < 0.001) after the mop-up training after a mean of 191 days. More than 30% increment was seen in knowledge about the stroke symptoms (35.9%, p < 0.001), avoiding opium after stroke for treatment (39.5%, p < 0.001), causes of stroke (53.3%, p < 0.001), modifiable risk factors for stroke (45.4%, p < 0.001), and lifestyle modifications for stroke prevention (42.1%, p < 0.001). Conclusions Focused group training can help enhance the knowledge of ASHAs about stroke prevention and management. ASHAs are also able to retain this complex multicomponent knowledge over a 6-month period. ASHA may be able to partake in reducing the secondary stroke burden in rural India. Thieme Medical and Scientific Publishers 2019-10 2019-12-12 /pmc/articles/PMC6908455/ /pubmed/31844374 http://dx.doi.org/10.1055/s-0039-3399396 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Jain, Maneeta
Pandian, Jeyaraj
Samuel, Clarence
Singh, Shavinder
Kamra, Deepshikha
Kate, Mahesh
Multicomponent Short-Term Training of ASHAs for Stroke Risk Factor Management in Rural India
title Multicomponent Short-Term Training of ASHAs for Stroke Risk Factor Management in Rural India
title_full Multicomponent Short-Term Training of ASHAs for Stroke Risk Factor Management in Rural India
title_fullStr Multicomponent Short-Term Training of ASHAs for Stroke Risk Factor Management in Rural India
title_full_unstemmed Multicomponent Short-Term Training of ASHAs for Stroke Risk Factor Management in Rural India
title_short Multicomponent Short-Term Training of ASHAs for Stroke Risk Factor Management in Rural India
title_sort multicomponent short-term training of ashas for stroke risk factor management in rural india
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908455/
https://www.ncbi.nlm.nih.gov/pubmed/31844374
http://dx.doi.org/10.1055/s-0039-3399396
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