Michelle Nichols1, Fred Stephen Sarfo2, Arti Singh3, Suparna Qanungo4, Frank Treiber4, Bruce Ovbiagele5, Raelle Saulson5, Sachin Patel4, Carolyn Jenkins4. 1. Medical University of South Carolina, College of Nursing, Charleston, South Carolina. Electronic address: nicholmg@musc.edu. 2. Department of Medicine, Neurology Unit, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana. 3. KNUST Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 4. Medical University of South Carolina, College of Nursing, Charleston, South Carolina. 5. Department of Neurology, Medical University of South Carolina, Charleston, South Carolina.
Abstract
BACKGROUND: There has been a tremendous surge in stroke prevalence in sub-Saharan Africa. Hypertension (HTN), the most potent, modifiable risk factor for stroke, is a particular challenge in sub-Saharan Africa. Culturally sensitive, efficacious HTN control programs that are timely and sustainable are needed, especially among stroke survivors. Mobile health (mHealth) technology and task-shifting offer promising approaches to address this need. METHODS: Using a concurrent triangulation design, we collected data from stroke survivors, caregivers, community leaders, clinicians and hospital personnel to explore the barriers, facilitators and perceptions toward mHealth related to HTN management among poststroke survivors in Ghana. Exploration included perceptions of a nurse-led navigational model to facilitate care delivery and willingness of stroke survivors and caregivers to use mHealth technology. RESULTS: Two hundred stroke survivors completed study surveys while focus groups (n = 4) were conducted with stroke survivors, caregivers and community leaders (n = 28). Key informant interviews were completed with clinicians and hospital personnel (n = 10). A total of 93% of survey respondents had HTN (60% uncontrolled). Findings support mHealth strategies for poststroke care delivery and HTN management and for task-shifting through a nurse-led model. Of survey and focus group participants, 76% and 78.6%, respectively, have access to mobile phones and 90% express comfort in using mobile phones and conveyed assurance that task-shifting through a nurse-led model could facilitate management of HTN. Findings also identified barriers to care delivery and medication adherence across all levels of the social ecological model. CONCLUSIONS: Participants strongly supported enhanced care delivery through mobile health and were receptive toward a nurse-led navigational model.
BACKGROUND: There has been a tremendous surge in stroke prevalence in sub-Saharan Africa. Hypertension (HTN), the most potent, modifiable risk factor for stroke, is a particular challenge in sub-Saharan Africa. Culturally sensitive, efficacious HTN control programs that are timely and sustainable are needed, especially among stroke survivors. Mobile health (mHealth) technology and task-shifting offer promising approaches to address this need. METHODS: Using a concurrent triangulation design, we collected data from stroke survivors, caregivers, community leaders, clinicians and hospital personnel to explore the barriers, facilitators and perceptions toward mHealth related to HTN management among poststroke survivors in Ghana. Exploration included perceptions of a nurse-led navigational model to facilitate care delivery and willingness of stroke survivors and caregivers to use mHealth technology. RESULTS: Two hundred stroke survivors completed study surveys while focus groups (n = 4) were conducted with stroke survivors, caregivers and community leaders (n = 28). Key informant interviews were completed with clinicians and hospital personnel (n = 10). A total of 93% of survey respondents had HTN (60% uncontrolled). Findings support mHealth strategies for poststroke care delivery and HTN management and for task-shifting through a nurse-led model. Of survey and focus group participants, 76% and 78.6%, respectively, have access to mobile phones and 90% express comfort in using mobile phones and conveyed assurance that task-shifting through a nurse-led model could facilitate management of HTN. Findings also identified barriers to care delivery and medication adherence across all levels of the social ecological model. CONCLUSIONS:Participants strongly supported enhanced care delivery through mobile health and were receptive toward a nurse-led navigational model.
Authors: Eni C Okonofua; Kit N Simpson; Ammar Jesri; Shakaib U Rehman; Valerie L Durkalski; Brent M Egan Journal: Hypertension Date: 2006-01-23 Impact factor: 10.190
Authors: Alan S Go; Dariush Mozaffarian; Véronique L Roger; Emelia J Benjamin; Jarett D Berry; Michael J Blaha; Shifan Dai; Earl S Ford; Caroline S Fox; Sheila Franco; Heather J Fullerton; Cathleen Gillespie; Susan M Hailpern; John A Heit; Virginia J Howard; Mark D Huffman; Suzanne E Judd; Brett M Kissela; Steven J Kittner; Daniel T Lackland; Judith H Lichtman; Lynda D Lisabeth; Rachel H Mackey; David J Magid; Gregory M Marcus; Ariane Marelli; David B Matchar; Darren K McGuire; Emile R Mohler; Claudia S Moy; Michael E Mussolino; Robert W Neumar; Graham Nichol; Dilip K Pandey; Nina P Paynter; Matthew J Reeves; Paul D Sorlie; Joel Stein; Amytis Towfighi; Tanya N Turan; Salim S Virani; Nathan D Wong; Daniel Woo; Melanie B Turner Journal: Circulation Date: 2013-12-18 Impact factor: 29.690
Authors: Rhonda BeLue; Titilayo A Okoror; Juliet Iwelunmor; Kelly D Taylor; Arnold N Degboe; Charles Agyemang; Gbenga Ogedegbe Journal: Global Health Date: 2009-09-22 Impact factor: 4.185
Authors: Alessandro Biffi; Christopher D Anderson; Thomas W K Battey; Alison M Ayres; Steven M Greenberg; Anand Viswanathan; Jonathan Rosand Journal: JAMA Date: 2015-09-01 Impact factor: 56.272
Authors: Viktoria Fruhwirth; Christian Enzinger; Elisabeth Weiss; Andreas Schwerdtfeger; Thomas Gattringer; Daniela Pinter Journal: Wien Med Wochenschr Date: 2019-09-18
Authors: Fred Stephen Sarfo; Linda Meta Mobula; Titus Adade; Yvonne Commodore-Mensah; Martin Agyei; Collins Kokuro; Rexford Adu-Gyamfi; Christiana Duah; Bruce Ovbiagele Journal: J Neurol Sci Date: 2020-03-04 Impact factor: 3.181
Authors: Samuel Kwasi Opoku; Walter Leal Filho; Fudjumdjum Hubert; Oluwabunmi Adejumo Journal: Int J Environ Res Public Health Date: 2021-04-27 Impact factor: 3.390