TY - JOUR
T1 - Core health-components, contextual factors and program elements of community-based interventions in Southeast Asia
T2 - a realist synthesis regarding hypertension and diabetes
AU - Pardoel, Zinzi E.
AU - Reijneveld, Sijmen A.
AU - Lensink, Robert
AU - Widyaningsih, Vitri
AU - Probandari, Ari
AU - Stein, Claire
AU - Hoang, Giang Nguyen
AU - Koot, Jaap A. R.
AU - Fenenga, Christine J.
AU - Postma, Maarten
AU - Landsman, Johanna A.
PY - 2021/10/22
Y1 - 2021/10/22
N2 - BackgroundIn Southeast Asia, diabetes and hypertension are on the rise and have become major causes of death. Community-based interventions can achieve the required behavioural change for better prevention. The aims of this review are 1) to assess the core health-components of community-based interventions and 2) to assess which contextual factors and program elements affect their impact in Southeast Asia.MethodsA realist review was conducted, combining empirical evidence with theoretical understanding. Documents published between 2009 and 2019 were systematically searched in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar and PsycINFO and local databases. Documents were included if they reported on community-based interventions aimed at hypertension and/or diabetes in Southeast Asian context; and had a health-related outcome; and/or described contextual factors and/or program elements.ResultsWe retrieved 67 scientific documents and 12 grey literature documents. We identified twelve core health-components: community health workers, family support, educational activities, comprehensive programs, physical exercise, telehealth, peer support, empowerment, activities to achieve self-efficacy, lifestyle advice, activities aimed at establishing trust, and storytelling. In addition, we found ten contextual factors and program elements that may affect the impact: implementation problems, organized in groups, cultural sensitivity, synergy, access, family health/worker support, gender, involvement of stakeholders, and referral and education services when giving lifestyle advice.ConclusionsWe identified a considerable number of core health-components, contextual influences and program elements of community-based interventions to improve diabetes and hypertension prevention. The main innovative outcomes were, that telehealth can substitute primary healthcare in rural areas, storytelling is a useful context-adaptable component, and comprehensive interventions can improve health-related outcomes. This extends the understanding of promising core health-components, including which elements and in what Southeast Asian context.
AB - BackgroundIn Southeast Asia, diabetes and hypertension are on the rise and have become major causes of death. Community-based interventions can achieve the required behavioural change for better prevention. The aims of this review are 1) to assess the core health-components of community-based interventions and 2) to assess which contextual factors and program elements affect their impact in Southeast Asia.MethodsA realist review was conducted, combining empirical evidence with theoretical understanding. Documents published between 2009 and 2019 were systematically searched in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar and PsycINFO and local databases. Documents were included if they reported on community-based interventions aimed at hypertension and/or diabetes in Southeast Asian context; and had a health-related outcome; and/or described contextual factors and/or program elements.ResultsWe retrieved 67 scientific documents and 12 grey literature documents. We identified twelve core health-components: community health workers, family support, educational activities, comprehensive programs, physical exercise, telehealth, peer support, empowerment, activities to achieve self-efficacy, lifestyle advice, activities aimed at establishing trust, and storytelling. In addition, we found ten contextual factors and program elements that may affect the impact: implementation problems, organized in groups, cultural sensitivity, synergy, access, family health/worker support, gender, involvement of stakeholders, and referral and education services when giving lifestyle advice.ConclusionsWe identified a considerable number of core health-components, contextual influences and program elements of community-based interventions to improve diabetes and hypertension prevention. The main innovative outcomes were, that telehealth can substitute primary healthcare in rural areas, storytelling is a useful context-adaptable component, and comprehensive interventions can improve health-related outcomes. This extends the understanding of promising core health-components, including which elements and in what Southeast Asian context.
KW - Community-based interventions
KW - Southeast Asia
KW - Non-communicable diseases
KW - Diabetes
KW - Hypertension
KW - Core health-components
KW - Contextual factors
KW - Program elements
KW - Realist synthesis
KW - review
KW - SELF-MANAGEMENT
KW - SUPPORT
KW - PREVENTION
KW - COUNTRIES
KW - QUALITY
U2 - 10.1186/s12889-021-11244-3
DO - 10.1186/s12889-021-11244-3
M3 - Article
SN - 1471-2458
VL - 21
JO - BMC Public Health
JF - BMC Public Health
M1 - 1917
ER -