The Perspectives of Lagos Healthcare Leaders on Faith-Institution Involvement in Hypertension Health.

BACKGROUND: Hypertension is an important challenge for the Nigerian healthcare system and multiple stakeholder mitigation is imperative. Faith institution mitigation is evolving but the opinion of healthcare leaders on their involvement in hypertension remains an important gap. OBJECTIVE: To explore the perspectives of a cross-section of leaders of healthcare institutions in Lagos (Nigeria) on faith institution-facilitated hyper tension inter vention against the background of current practice. METHODS: Attempts were made to recruit 152 healthcare institution leaders who were contacted using electronic mails, telephone conversations, institutional social media communication, institutions' web-mails and other contacts. The views of consenting leaders were gathered using an exploratory questionnaire survey, and analysed. RESULTS: The views of 23 leaders from the variety of institutions were that most (60%) hypertension cases were diagnosed during emergency presentations; and the public's hypertension health knowledge remains generally inadequate. Hypertension information dissemination was mostly verbal rather than in written/print form. Basic resources are deployed in hypertension management. There was majority support for collaboration in hypertension health promotion (90.0%), blood pressure screening (95.7%) and hypertension referral (95.5%). Fewer institutions had the resources to support hypertension health promotion (55.0%) and blood pressure screening (42.1%) compared to hypertension referral (90.9%). CONCLUSION: There is good support for faith institution involvement in hypertension health, with a particular interest in and capacity for health system referral. Deploying scarce resources to collaborate may be challenging. However, collaboration and better resources could improve hypertension prevention and management. Further work is needed for context specific innovation so faith institutions can contribute to hypertension health.

CONTEXTE: L'hypertension représente un défi majeur pour le système de santé nigérian, et une atténuation impliquant plusieurs parties prenantes est impérative. L'atténuation par les institutions religieuses est en évolution, mais l'opinion des leaders de la santé sur leur implication dans l'hypertension reste une lacune importante. OBJECTIF: Explorer les perspectives d'un échantillon de leaders d'institutions de santé à Lagos, Nigeria, sur l'intervention contre l'hypertension facilitée par les institutions religieuses, dans le contexte de la pratique actuelle. MÉTHODES: Des tentatives ont été faites pour recruter 152 dirigeants d'établissements de santé qui ont été contactés par courriels électroniques, conversations téléphoniques, communication sur les médias sociaux institutionnels, courriers électroniques des établissements et autres contacts. Les points de vue des dirigeants consentants ont été recueillis à l'aide d'une enquête par questionnaire exploratoire, puis analysés. RÉSULTATS: Les opinions de 23 dirigeants provenant de divers établissements indiquaient que la plupart des cas d'hypertension (60%) étaient diagnostiqués lors de présentations aux urgences; et les connaissances du public sur la santé liée à l'hypertension demeurent généralement insuffisantes. La diffusion d'informations sur l'hypertension se faisait principalement de manière verbale plutôt que sous forme écrite/imprimée. Des ressources de base sont utilisées dans la gestion de l'hypertension. Une majorité soutenait la collaboration dans la promotion de la santé liée à l'hypertension (90,0%), le dépistage de la tension artérielle (95,7%) et l'orientation des patients atteints d'hypertension (95,5%). Moins d'institutions avaient les ressources pour soutenir la promotion de la santé liée à l'hypertension (55,0 %) et le dépistage de la pression artérielle (42,1 %) par rapport à l'orientation vers l'hypertension (90,9 %). CONCLUSION: Il existe un soutien significatif pour l'implication des institutions religieuses dans la santé liée à l'hypertension, avec un intérêt particulier et une capacité à orienter vers le système de santé. Le déploiement de ressources limitées pour la collaboration peut présenter des défis. Cependant, la collaboration et de meilleures ressources pourraient améliorer la prévention et la gestion de l'hypertension. Des travaux supplémentaires sont nécessaires pour des innovations spécifiques au contexte afin que les institutions religieuses puissent contribuer à la santé liée à l'hypertension. MOTS- CLÉS: Hypertension, Lagos, Institutions religieuses, Responsables de la santé, Intervention.

Improving balance in community-dwelling elders using trained volunteers within faith-based institutions: a mixed methods feasibility study.

PURPOSE: To investigate the feasibility and acceptability of a volunteer-led balance programme for older adults. METHODS: A feasibility cluster RCT with focus groups were conducted in faith-based institutions. Eligibility criteria were: participants were ≥65 years, able to do five times sit -to-stand, had no falls in the previous six months and had good mental capacity. The intervention included supervised group exercises and exercise booklets for six months, education and a fall poster. Assessments included, TUG, MCTSiB, FTST, FES, mABC, OPQoL and DGLS at baseline, 6 weeks, and 6 months. Feasibility measures included numbers of volunteers, sessions, and volunteers" time commitment, views of participants about sustainability of program using qualitative focus groups and volunteers' ability to deliver programme. RESULTS: Three churches participated with 31 participants in each group. Participants had a mean age of 77.3 years, were 100% British, and 79% female. The sample size estimate for a future trial using TUG, was 79 per group. Focus groups showed perceived social and physical improvements in participants, need to extend the programme to the wider community, and increased confidence, participation and socialisation. CONCLUSION: The community-based balance training in faith-based institutions, was feasible and acceptable in one geographical area and requires evaluation in cohesive diverse communities.Implications for RehabilitationIf an institution or a community is united through faith, culture, national roots, or tradition, then these groups are ideal for such balance rehabilitation programmes, because of the familiarity of the location and people, cohesive culture or their ideology to help their communities.Participants and volunteers perceived improved participation, confidence and socialisation and were keen to continue programme.It is important to develop community-based falls prevention programmes that the National Health Service (NHS) can partially support using volunteers to reduce the burden of falls in the community and for the NHS.