Participatory Action for Optimizing Health Literacy and Access to Manage Hypertension: Pre-post Evaluation in a Marginalized Community of India
We used a participatory action research (PAR) strategy for optimizing health literacy and access (Ophelia) to improve hypertension (HTN) management in a peri-urban village of Chandigarh (India). We used an embedded mixed method design for development, implementation, and evaluation. Through communit...
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SAGE Publishing
2025-06-01
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| author | Reetu Passi Manmeet Kaur Madhu Gupta Savita Kumari Rajesh Kumar |
| author_facet | Reetu Passi Manmeet Kaur Madhu Gupta Savita Kumari Rajesh Kumar |
| author_sort | Reetu Passi |
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| description | We used a participatory action research (PAR) strategy for optimizing health literacy and access (Ophelia) to improve hypertension (HTN) management in a peri-urban village of Chandigarh (India). We used an embedded mixed method design for development, implementation, and evaluation. Through community consultations and vignettes created from interviews with population sub-groups and input from healthcare providers, we co-designed the intervention. Volunteers facilitated community-based awareness activities like door-to-door interaction, mobile messages, posters, collaboration with healthcare providers, and free blood pressure monitoring services. At the health facility, we improved communication by re-orienting healthcare providers and introducing medication adherence charts after identifying gaps through patients’ journeys. We measured changes in health literacy, HTN knowledge, risk factors, medication adherence, and HTN control in a sample of 510 randomly selected adults in pre and post-intervention design using chi-square and t -test. A checklist assessed community capacity and multivariable regression adjusted the effect of confounders. Health literacy significantly improved across most scales (beta range 0.17 to 0.76, p < 0.01). Hypertension knowledge scores increased from 2.9 to 3.4 ( p < 0.05). Physical activity (≥1,500 MET min/week) (aOR 0.19, 95% CI 0.11 to 0.33, p < 0.01) and daily salt consumption (<5 g/day) (aOR 0.47, 95% CI 0.36 to 0.6, p < 0.01) improved. However, body weight, tobacco and alcohol use remained unchanged. Medication adherence (aOR 0.08; 95% CI 0.02 to 0.32 p < 0.01) and HTN control (aOR 0.28; 95% CI 0.08 to 0.94; p = −0.04) increased. Community capacity in leadership, planning, management, learning and skill development received high rating. |
| format | Article |
| id | doaj-art-4d7d50b1cfce4b66811d921c5cd92cb4 |
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| issn | 2158-2440 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SAGE Publishing |
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| series | SAGE Open |
| spelling | doaj-art-4d7d50b1cfce4b66811d921c5cd92cb42025-08-20T02:07:59ZengSAGE PublishingSAGE Open2158-24402025-06-011510.1177/21582440251339053Participatory Action for Optimizing Health Literacy and Access to Manage Hypertension: Pre-post Evaluation in a Marginalized Community of IndiaReetu Passi0Manmeet Kaur1Madhu Gupta2Savita Kumari3Rajesh Kumar4Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaWe used a participatory action research (PAR) strategy for optimizing health literacy and access (Ophelia) to improve hypertension (HTN) management in a peri-urban village of Chandigarh (India). We used an embedded mixed method design for development, implementation, and evaluation. Through community consultations and vignettes created from interviews with population sub-groups and input from healthcare providers, we co-designed the intervention. Volunteers facilitated community-based awareness activities like door-to-door interaction, mobile messages, posters, collaboration with healthcare providers, and free blood pressure monitoring services. At the health facility, we improved communication by re-orienting healthcare providers and introducing medication adherence charts after identifying gaps through patients’ journeys. We measured changes in health literacy, HTN knowledge, risk factors, medication adherence, and HTN control in a sample of 510 randomly selected adults in pre and post-intervention design using chi-square and t -test. A checklist assessed community capacity and multivariable regression adjusted the effect of confounders. Health literacy significantly improved across most scales (beta range 0.17 to 0.76, p < 0.01). Hypertension knowledge scores increased from 2.9 to 3.4 ( p < 0.05). Physical activity (≥1,500 MET min/week) (aOR 0.19, 95% CI 0.11 to 0.33, p < 0.01) and daily salt consumption (<5 g/day) (aOR 0.47, 95% CI 0.36 to 0.6, p < 0.01) improved. However, body weight, tobacco and alcohol use remained unchanged. Medication adherence (aOR 0.08; 95% CI 0.02 to 0.32 p < 0.01) and HTN control (aOR 0.28; 95% CI 0.08 to 0.94; p = −0.04) increased. Community capacity in leadership, planning, management, learning and skill development received high rating.https://doi.org/10.1177/21582440251339053 |
| spellingShingle | Reetu Passi Manmeet Kaur Madhu Gupta Savita Kumari Rajesh Kumar Participatory Action for Optimizing Health Literacy and Access to Manage Hypertension: Pre-post Evaluation in a Marginalized Community of India SAGE Open |
| title | Participatory Action for Optimizing Health Literacy and Access to Manage Hypertension: Pre-post Evaluation in a Marginalized Community of India |
| title_full | Participatory Action for Optimizing Health Literacy and Access to Manage Hypertension: Pre-post Evaluation in a Marginalized Community of India |
| title_fullStr | Participatory Action for Optimizing Health Literacy and Access to Manage Hypertension: Pre-post Evaluation in a Marginalized Community of India |
| title_full_unstemmed | Participatory Action for Optimizing Health Literacy and Access to Manage Hypertension: Pre-post Evaluation in a Marginalized Community of India |
| title_short | Participatory Action for Optimizing Health Literacy and Access to Manage Hypertension: Pre-post Evaluation in a Marginalized Community of India |
| title_sort | participatory action for optimizing health literacy and access to manage hypertension pre post evaluation in a marginalized community of india |
| url | https://doi.org/10.1177/21582440251339053 |
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