A community process evaluation will also be undertaken during the project in order to monitor the implementation of the CHAP-P intervention to assess for any problems or process issues during or after the implementation of the project. The questions include: demographics; knowledge about diabetes and cardiovascular health; risk factors and behaviours, including the Finnish Diabetes Risk Calculator (FINDRISC) [23]; quality of life using the EQ-5D-5 L [24, 25]; perceived confidence; perceived concern and understanding of risk; self-efficacy to improve health behaviours; physical activity using the International Physical Activity Questionnaire (IPAQ) [22]; and health utilization and access. After completing the community survey in their homes, these participants will be invited to a community location where they will have their glycated hemoglobin (HbA1c) tested using the A1CNow + point-of-care device, which is certified by the National Glycohemoglobin Standardization Program [28]. Home Publications Conferences Register … As of 2013, an estimated 382 million people are living with type 2 diabetes globally, with the large majority of these individuals living in low- to middle-income countries (LMICs) [1]. Only 15-25% of jobs in the Philippines are provided for the nursing population. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. Some community-based programs for type 2 diabetes tested in other LMICs including elements such as educational sessions, lifestyle instruction, and self-monitoring have shown significant positive outcomes including lowering weight, waist circumference, fasting plasma glucose levels, and HbA1c [33, 34]. Community Health Nursing Reflection 1262 Words | 6 Pages. The WatchBP Office Target will be used to measure blood pressure as it was found to show the most reliable results based on our pilot study [27]. Amendment of certain sections of the Act 2008 was conducted in … During World War II, the Philippines repeatedly exchanged hands between … Correspondence to 2017;14. https://doi.org/10.3390/ijerph14040417. Secondary outcomes: modifiable risk factors, health utilization and access (individual); diabetes detection and management (cluster). 2008;336:1180–5. The Philippines is a culturally and historically diverse archipelago consisting of a cluster of over 7,000 islands in the Southeast Pacific Rim. 2014;103:150–60. 2016;17:8. ; Filipino Nurses Association. Lindstrom J, Tuomilehto J. Graduates of BS in Nursing may pursue a career path in various hospital settings and community clinics. 2010;30:186–90. Presented at the North American Primary Care Group (NAPCRG) Annual Meeting. Philippine Health Care Laws. The Cardiovascular Health Awareness Program (CHAP), an evidence-based Canadian intervention, may be an appropriate model for LMICs due to its low cost, ease of implementation, and focus on health promotion and disease prevention. Finally, the health economics component of this study will provide policymakers and funders the information they need to decide whether implementation of a program such as CHAP-P is cost-effective for their communities. Ardena GJRA, Paz-Pacheco E, Jimeno CA, Lantion-Ang FL, Paterno E, Juban N. Knowledge, attitudes and practices of persons with type 2 diabetes in a rural community: phase I of the community-based diabetes self-management education (DSME) program in San Juan, Batangas, Philippines. The intervention was based on the evidence-based CHAP model from Canada, though needed to be adapted for the local context. volume 19, Article number: 682 (2019) Due to the variation in communities across the Philippines, the focus on a community-level approach is a key element in making a program such as CHAP-P work. Criteria for community selection include: security, connection with a local champion, feasibility for travel, and facility with refrigerated space for the HbA1c kits. Finally, Phase 3 is the RCT described in this paper. EuroQol G. EuroQol--a new facility for the measurement of health-related quality of life. ClinicalTrials.gov (NCT03481335), registered March 29, 2018. Electronic data will be stored in an encrypted program (REDCap) or in password-protected files on a secure institutional network. CHAP-P participants are community residents aged 40 years of age or older. Ku GM, Kegels G. The performance of the Finnish diabetes risk score, a modified Finnish diabetes risk score and a simplified Finnish diabetes risk score in community-based cross-sectional screening of undiagnosed type 2 diabetes in the Philippines. The second participant group are those that attend the CHAP-P sessions. ISSN: 0048-3818: OCLC Number: 4841184: Description: volumes illustrations 25 cm: Other Titles: Philippine journal of nursing 2003;26:725–31. 1990;16:199–208. Communities will be selected and randomized by the local program manager. Diabetes Care. Second, the mobile HbA1c test kit can be difficult to work with, as it only lasts for approximately 5 minutes in the heat and humidity of the Philippines. 2013;25:92–101. This will be done based on the advice of the local health workers and leaders in the municipalities and cities. BMC Public Health. For example, though screening kits and medications are available at no cost, the case detection for new cases of diabetes is poor, the diabetes registry is poorly maintained, and the medications often get left unused in the stockrooms of local health centres (Dr M.A. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. (DOCX 165 kb), Consent Form – CHAP-P Session Participant. Therefore, adopting and testing an effective low-cost intervention that enhances early diagnosis and management of diabetes shows promise for LMICs. https://www.doh.gov.ph/node/837. The Filipino Nurses Association was established on October 15, and the organization initiated the publication of Filipino Nurse Journal. The community health nursing relationship style, a partnership of care, is less authoritarian and more egalitarian than the relationship of a nurse and a hospitalized patient. QSR international Pty ltd. 2015. Based on findings during the assessment, BHWs will educate the CHAP-P participants on diabetes, cardiovascular risk factors, and healthy lifestyles, providing educational materials that have been adapted for a local context (including materials such as pamphlets, comic strips, and videos). Cookies policy. The remainder of the work force go on to seek out other professional career opportunities outside the country. The funding bodies had no role in study design, collection, analysis, interpretation of data, or in writing the manuscript. For CHAP-P session participants, the FINDRISC, blood pressure, and other physical measurement data collected as part of the CHAP-P sessions will be included in the evaluation. Article  Zamboanga Peninsula is an Administrative Region of the Philippines on the island of Mindanao in the southern Philippines consisting of three provinces (Zamboanga del Norte, Zamboanga del Sur, and Zamboanga Sibugay) and two independent cities (Isabela and Zamboanga City). H Index. Pages: 179-188. Article  Agarwal G, Angeles R, Pirrie M, Marzanek F, McLeod B, Parascandalo J, Dolovich L. Effectiveness of a community paramedic-led health assessment and education initiative in a seniors’ residence building: the community health assessment program through emergency medical services (CHAP-EMS). In the home setting, clients have more control over their behaviors in relation to the plan of care; they choose whether or not to follow special diets, exercise regimens, or medication schedules. 2013;13:423. This will be done through paired randomization with staggered starts. van Olmen J, Ku GM, van Pelt M, Kalobu JC, Hen H, Darras C, Van Acker K, Villaraza B, Schellevis F, Kegels G. The effectiveness of text messages support for diabetes self-management: protocol of the TEXT4DSM study in the democratic republic of Congo, Cambodia and the Philippines. The Philippine National Bank has also reacted with programs that encourage remittance flows, and special remittance centers have been created in various parts of the U.S. Of course, there are negative effects as well. Social innovations can bring scientific solutions to a local setting, while business innovations can deliver them at an affordable price point. Committee NS: the national glycohemoglobin standardization program: a five-year progress report. Health Policy. CHAP-P sessions will continue to be held twice a month in intervention communities, and residents will be encouraged to continue attending for ongoing follow-up and monitoring. Browse the list of issues and latest articles from Journal of Community Health Nursing. § What is Community Health Nursing? First, 100 participants will be randomly selected and recruited from each of the 26 barangays involved in the trial for a community survey. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Package of essential noncommunicable (PEN) disease interventions for primary health Care in low-resource Settings. They will be recruited through convenience sampling with research team members inviting those who have been involved with the CHAP-P intervention. Journal of Community Health Nursing, Volume 37, Issue 4 (2020) Research Article . JG contributed to drafting of the article, acquisition of ethical approval, and registration to Clinical Trials with GA and RNA. 2004;82:581–629. This community survey will be completed at baseline and at 6 months and will use an open-cohort design. Focus group discussions will be held at 6 months for study participants, BHWs, and other LLO staff using a standardized focus group guide consisting of open-ended questions primarily focused on identifying the barriers and facilitators to implementing CHAP-P. Further sources of data include monthly community reports from the communities, monthly observational checklists by research assistants, and record review of the CHAP-P session databases and Rural Health Unit databases. The stepped wedge cluster randomised trial: rationale, design, analysis, and reporting. Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N. Lost in knowledge translation: time for a map? The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. First, residents will be invited to attend the CHAP-P sessions, which are facilitated by Barangay Health Workers (BHWs), who are trained local volunteers. Accessed 8 Feb 2019. However, there are currently some gaps in the areas of detection and treatment for diabetes. Google ScholarÂ. Ku GMV, Kegels G. Knowledge, attitudes and perceptions of people with type 2 diabetes as related to self-management practices: results of a cross-sectional study conducted in Luzon, Philippines. HEALTH FINANCING The health financing system in the country is complex as it involves different layers of financial sources, regulatory bodies and health service providers. A member of the research staff team will ask individuals selected to participate in the study to provide consent, and the survey will be conducted with consenting individuals (See Additional files 1, 2, 3 and 4 for all consent forms). The survey participants are not necessarily the same individuals who will attend the CHAP-P sessions in intervention communities, though entire communities will be invited to the CHAP-P sessions. Though we combined many elements to fit the program to the setting, there are still some limitations that warrant consideration. For the community survey and CHAP-P session data, after the full data set is collected (including the HbA1c test results), data will be anonymized. Public Health Nursing is proud to announce that it is now the official journal of Council of Public Health Nursing Organizations (CPHNO) (formerly known as the Quad Council Coalition of Public Health Nursing Organizations), www.cphno.org There will be three participant groups in the study. 2015;38:506–14. During the CHAP-P sessions, the BHWs will collect participants’ consent, measure blood pressure, collect other physical measurements (height, weight, waist circumference), and collect participant information to determine clients’ risk of diabetes using the FINDRISC [23]. Not only do community health nurses deliver patient care, they also help reduce the occurrence of injuries, illnesses and deaths by informing people about health … Study data will be anonymized. 1998;280:1757–63. A community cluster design was chosen as CHAP-P is intended as a community-level intervention. The trial is also registered with ClinicalTrials.gov (identifier NCT03481335, first posted March 29, 2018; last updated August 17, 2018). No man, not even a doctor, ever gives any other definition of what a nurse should be than this — "devoted and obedient." 1996;37:53–72. Nurses can help clients internalize the importance of healthy behaviors by teaching and adapting the care plan to the individual client. The number of people with diabetes is expected to increase significantly by 2035, with the projected increase higher in low (108%) and low-middle income (60%) countries compared to upper-middle (51%) and high income (28%) countries [1]. It catapulted community health nursing to the center of emergency response plans that would provide mass prophylaxis and contain and manage biochemical threats. The secondary aims are to determine CHAP-P’s effectiveness compared to usual care in impacting: i) modifiable lifestyle risk factors for developing type 2 diabetes; ii) self-reported health utilization and access to care; iii) diabetes detection and management indicators in clusters (screening rates, initiation of medical management, hospital admissions, and mortality due to diabetes and its complications); and iv) program cost-effectiveness and cost-utility. BMJ. It considers original articles written for, but not limited to, Filipino nurses at all levels of health care organizations and in various settings. The primary aim of this study is to adapt the CHAP model to a Philippine context as the Community Health Assessment Program in the Philippines (CHAP-P) and evaluate the effect of CHAP-P on glycated hemoglobin (HbA1c) compared to a random sample of community residents in control communities. Related Journals: Journal of Community & Public Health Nursing , Journal of Nursing & Care , Research & Reviews: Journal of Nursing and Health Sciences , Journal of Nursing & Patient Care, Advanced Practices in Nursing The CHAP-P intervention was developed through a multi-stage study that combined specific elements of the CHAP and CHAD, adapting the intervention to be more appropriate for LMICs in general and the local setting of communities in Southwestern Philippines (Zamboanga Peninsula) in particular. The overall project is a three-phase mixed methods evaluation. Healthcare should be accessible to everyone. Winslow, Public Health is a science & art of 3 P’s§ Prevention of Disease§ Prolonging life§ Promotion of health and efficiency through organized community effort 6. Part of BMJ. All p-values will be reported to three decimal places with those less than 0.001 reported as p < 0.001. Agarwal, G., Angeles, R.N., Dolovich, L. et al. Department of Health (DOH): What is barangay health worker? Telephone Nos: 521-0937, 400-4430 The Philippine Journal of Health Research and Development (PJHRD) (formerly the UP Manila Journal) is a peer-reviewed journal that aims to publish researches with a broad scope covering all aspects of environmental and human health. The Pragmatic-Explanatory Continuum Indicator Summary 2 (PRECIS-2) [18] was used to make design decisions based on the pragmatism of the trial (see Fig. 2). The Integrated Innovation approach will be combined with the knowledge-to-action process, which depicts the relationship between knowledge creation and action steps to promote the application of knowledge (in our case the generation of CHAP-P) and evaluation of the success of the actions taken [16]. In 2012, this region had the fourth highest poverty incidence of the 17 regions of the Philippines (33.7%) [17]. CAS  Public Health Nursing: the term used before for Community Health NursingAccording to Dr. C.E. Related Posts. The Philippine Health Agenda 2016 to 2022. Type 2 diabetes is increasing globally, with the highest burden in low- to middle-income countries (LMICs) such as the Philippines. Hardin JW, Hilbe JM. Healthcare for expats in The Philippines is affordable and good quality in and around Manila. Consent Form – Community Survey Participant. Percentage decrease in participant HbA1c will be the measure of effectiveness used in the cost-effectiveness analysis. Health care in the Philippines has been defined by the WHO as "fragmented", meaning there's a large gap between the quality and quantity of health services for the poor and the rich. Choosing the optimal method of blood pressure measurement for limited-resource rural communities in the “community health assessment program-Philippines”. List of issues Volume 37 2020 Volume 36 2019 Volume 35 2018 Volume 34 2017 Volume 33 2016 Volume 32 2015 Volume 31 2014 Volume 30 2013 Volume 29 2012 Volume 28 … 2008;46:537–44. “Community health impacts everything—educational achievement, safety and crime, people’s ability to work and be financially healthy, life expectancy, happiness and more,” Bognanno says. Six-month, 26-community (13 intervention, 13 control) parallel cluster randomized controlled trial in Zamboanga Peninsula, an Administrative Region in the southern Philippines. Mabolo, Philippine Department of Health, personal communication, June 16, 2014). Within selected households, individuals 40 years of age or older will be eligible to participate in the survey. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Our sample size for individuals was calculated based on a mean difference of HBA1c of 0.2% (SD = 1.09) with standard parameters (alpha = 0.05, power = 0.80). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Those with other specific risk factors such as low physical activity, high salt intake, or smoking will be given further health education and referred to appropriate local programs. The BHW role is a voluntary position accredited by local health boards, which provides primary health care service to the barangays [29]. HYL and DO are contributing to the development of the methods for economic analysis. 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