The Department of Endocrinology, 
Evaluation of a training program of hypertension for accredited social health activists (ASHA) in rural India.
- The George Institute for Global Health, et Sydney, PO Box M 201, Missenden Road, Camperdown, New South Wales, 2050, Australia. mabdel-all@georgeinstitute.org.au.
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. mabdel-all@georgeinstitute.org.au.
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
- Amrita Institute of Medical Sciences, Kochi, Kerala, India.
- The George Institute for Global Health, et Sydney, PO Box M 201, Missenden Road, Camperdown, New South Wales, 2050, Australia.
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
- Western Sydney Local Health District, Westmead Hospital, Westmead, Australia.
- The George Institute for Global Health, New Delhi, India.
- The George Institute for Global Health, Oxford University, Oxford, UK.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
- Rishi Valley Rural Health Centre, Rishi Valley, Andhra Pradesh, India.
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia.
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
BMC health services research Vol. 18 · Issue 1 · pp. 320
PMID 29720161 DOI 10.1186/s12913-018-3140-8
Cite This Article
Marwa Abdel-All, Amanda Gay Thrift, Michaela Riddell, Kavumpurathu Raman Thankappan Thankappan, Gomathyamma Krishnakurup Mini, Clara K Chow, Pallab Kumar Maulik, Ajay Mahal, Rama Guggilla, Kartik Kalyanram, Kamakshi Kartik, Oduru Suresh, Roger George Evans, Brian Oldenburg, Nihal Thomas, Rohina Joshi. Evaluation of a training program of hypertension for accredited social health activists (ASHA) in rural India. BMC health services research. 2018;18(1):320. doi:10.1186/s12913-018-3140-8
Abstract
BACKGROUND: Hypertension is a major risk factor for cardiovascular disease, a leading cause of premature death and disability in India. Since access to health services is poor in rural India and Accredited Social Health Activists (ASHAs) are available throughout India for maternal and child health, a potential solution for improving hypertension control is by utilising this available workforce. We aimed to develop and implement a training package for ASHAs to identify and control hypertension in the community, and evaluate the effectiveness of the training program using the Kirkpatrick Evaluation Model.
METHODS: The training program was part of a cluster randomised feasibility trial of a 3-month intervention to improve hypertension outcomes in South India. Training materials incorporated details on managing hypertension, goal setting, facilitating group meetings, and how to measure blood pressure and weight. The 15 ASHAs attended a five-day training workshop that was delivered using interactive instructional strategies. ASHAs then led community-based education support groups for 3 months. Training was evaluated using Kirkpatrick's evaluation model for measuring reactions, learning, behaviour and results using tests on knowledge at baseline, post-training and post-intervention, observation of performance during meetings and post-intervention interviews.
RESULTS: The ASHAs' knowledge of hypertension improved from a mean score of 64% at baseline to 76% post-training and 84% after the 3-month intervention. Research officers, who observed the community meetings, reported that ASHAs delivered the self-management content effectively without additional assistance. The ASHAs reported that the training materials were easy to understand and useful in educating community members.
CONCLUSION: ASHAs can be trained to lead community-based group educational discussions and support individuals for the management of high blood pressure.
TRIAL REGISTRATION: The feasibility trial is registered with the Clinical Trials Registry - India (CTRI) CTRI/2016/02/006678 (25/02/2016).
Keywords
- ASHA
- Hypertension
- India
- Kirkpatrick evaluation model
- Training evaluation
