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Open Access 01-12-2024 | Hypertension | Research

Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa

Authors: Lia K. McNulty, Mark Stoutenberg, Andrea Kolkenbeck-Ruh, Amy Harrison, Thabiso Mmoledi, Daniel Katiyo, Mimi Mhlaba, Delisile Kubheka, Lisa J. Ware

Published in: BMC Public Health | Issue 1/2024

Abstract

Background

Low-and-middle income countries face a disproportionate burden of non-communicable diseases (NCDs) that threaten to overwhelm under-resourced health systems. Community health workers (CHWs) can promote NCD prevention, reach patients, and connect them to local community health resources; however, little has been done to examine how referrals to these resources are utilized by community members. The purpose of this study is to examine the use of referrals to community-based health resources and investigate the factors influencing patient utilization of referrals connecting them to appropriate health resources for elevated blood pressure (BP).

Methods

CHWs conducted home visits, which included BP screening and brief counseling, with community members in Soweto, South Africa. Participants with elevated (systolic BP: 121–139/ diastolic BP: 81–89 mmHg) or high (≥ 140/90 mmHg) BP were referred to either a local, community-based physical activity (PA) program managed by a non-governmental organization or local health clinics. The number of participants that received and utilized their referrals was tracked. Follow-up interviews were conducted with individuals given a referral who: (1) went to the PA program, (2) did not go to the PA program, (3) went to a clinic, and (4) did not go to a clinic. Interviews were transcribed and analyzed to identify common themes and differences between groups regarding their decisions to utilize the referrals.

Results

CHWs visited 1056 homes, with 1001 community members consenting to the screening; 29.2% (n = 292) of adults were classified as having optimal BP (≤120/80 mmHg), 35.8% (n = 359) had elevated BP, and 35.0% (n = 350) had high BP. One hundred and seventy-three participants accepted a referral to the PA program with 46 (26.6%) enrolling. Five themes emerged from the interviews: (1) prior knowledge and thoughts on BP, (2) psychosocial factors associated with BP control, (3) perception about receiving the referral, (4) contextual factors influencing referral utilization, and (5) perceived benefits of utilizing the referral.

Conclusion

CHWs can successfully increase community members’ access to health resources by providing appropriate referrals. However, greater attention needs to address community members’ barriers and hesitancy to utilize health resources.

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Title: Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa
Authors: Lia K. McNulty
Mark Stoutenberg
Andrea Kolkenbeck-Ruh
Amy Harrison
Thabiso Mmoledi
Daniel Katiyo
Mimi Mhlaba
Delisile Kubheka
Lisa J. Ware
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Hypertension
Hypertension
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-023-17359-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Examining the referral of patients with elevated blood pressure to health resources in an under-resourced community in South Africa

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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