Challenges in conducting communitybased trials of primary prevention of cardiovascular diseases in resourceconstrained rural settings.
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Date
2015-01
Journal Title
Journal ISSN
Volume Title
Publisher
WHO Regional Office for South-East Asia
Abstract
Cardiovascular diseases account for almost half of all deaths from noncommunicable
diseases, and almost 80% of these deaths occur in low- and middle-income
countries such as India. The PrePAre (Primary pREvention strategies at the
community level to Promote treatment Adherence to pREvent cardiovascular
disease) trial was a primary prevention trial of community health workers aimed
at improving adherence to prescribed pharmacological and nonpharmacological
therapies in cardiovascular diseases. It was conducted at three geographically,
culturally and linguistically diverse sites across India, comprising 28 villages and
5699 households. Planning and implementing large-scale community-based trials
is filled with numerous challenges that must be tackled, while keeping in mind the
local community dynamics. Some of the challenges are especially pronounced
when the focus of the activities is on promoting health in communities where
treating disease is considered a priority rather than maintaining health. This report
examines the challenges that were encountered while performing the different
phases of the trial, along with the solutions and strategies used to tackle those
difficulties. We must strive to find feasible and cost-effective solutions to these
challenges and thereby develop targeted strategies for primary prevention of
cardiovascular diseases in resource-constrained rural settings.
Description
Keywords
Cardiovascular diseases, challenges, community-based primary prevention trials, implementation
Citation
WHO South-East Asia Journal of Public Health 2015;4(1&2): 98-103.