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Jain P, Murali S, Mariam Jacob Q, Shivashankar R, Srivastava A, Joseph B, Raju M, Nesan S M, Damasceno A, Kaur P. An educational intervention for improving knowledge, attitude, and practice of dietary salt intake among individuals with hypertension in public sector secondary care facilities, Agra, India, 2021. J Clin Hypertens (Greenwich) 2024. [PMID: 38685612 DOI: 10.1111/jch.14817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 05/02/2024]
Abstract
We conducted a pre-post intervention study to determine knowledge, attitude, and practice toward dietary salt intake before, immediately, and 1-month after nurse-led one-on-one counseling. We purposively selected three public health facilities in Agra, India, and enrolled all eligible hypertensive patients aged 18-60 under treatment for ≥6 months. Of the 153 patients at the 1-month follow-up, counseling improved knowledge (4% vs. 42%, p < .001), a greater prioritization of a low salt diet (34% vs. 52%, p < .001), and practice of adding less salt to the dough (48% to 41%, p < .001). The counseling intervention improved knowledge, attitude, and practice toward dietary salt intake.
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Affiliation(s)
- Piyush Jain
- India Field Epidemiology Training Program, Indian Council of Medical Research - National Institute of Epidemiology (NIE), Chennai, India
- Department of Medical Health and Family Welfare, Government of Uttar Pradesh, Agra, India
| | - Sharan Murali
- India Field Epidemiology Training Program, Indian Council of Medical Research - National Institute of Epidemiology (NIE), Chennai, India
- Division of Noncommunicable Diseases, Indian Council of Medical Research - National Institute of Epidemiology (NIE), Chennai, India
| | - Quincy Mariam Jacob
- India Field Epidemiology Training Program, Indian Council of Medical Research - National Institute of Epidemiology (NIE), Chennai, India
| | | | - Arun Srivastava
- Department of Medical Health and Family Welfare, Government of Uttar Pradesh, Agra, India
| | - Bency Joseph
- Division of Epidemiology - Cancer Registry, Indian Council of Medical Research - National Center for Disease Informatics and Research, Bengaluru, India
| | - Mohankumar Raju
- India Field Epidemiology Training Program, Indian Council of Medical Research - National Institute of Epidemiology (NIE), Chennai, India
| | - Manikanda Nesan S
- India Field Epidemiology Training Program, Indian Council of Medical Research - National Institute of Epidemiology (NIE), Chennai, India
| | | | - Prabhdeep Kaur
- India Field Epidemiology Training Program, Indian Council of Medical Research - National Institute of Epidemiology (NIE), Chennai, India
- Division of Noncommunicable Diseases, Indian Council of Medical Research - National Institute of Epidemiology (NIE), Chennai, India
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Thomas R, Jacob QM, Raj Eliza S, Mini M, Jose J, A S. Financial Burden and Catastrophic Health Expenditure Associated with COVID-19 Hospitalizations in Kerala, South India. CEOR 2022; 14:439-446. [PMID: 35813122 PMCID: PMC9270006 DOI: 10.2147/ceor.s365999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Catastrophic health expenditure during COVID-19 hospitalization has altered the economic picture of households, especially in low resource settings with high rates of COVID-19 infection. This study aimed to estimate the out of pocket (OOP) expenditure and the proportion of households that incurred catastrophic health expenditure due to COVID-19 hospitalization in Kerala, South India. Materials and Methods A cross-sectional study was conducted among a representative sample of 155 COVID-19 hospitalized patients in Kottayam district over four months, using a pretested interview schedule. The direct medical and non-medical costs incurred by the study participants during hospitalization and the total monthly household expenditure were obtained from the respective COVID-19 affected households. Catastrophic health expenditure was defined as direct medical expenditure exceeding 40% of the household’s capacity to pay. Results From the study, median and mean OOP expenditure was obtained as USD 93.57 and USD 502.60 respectively. The study revealed that 49.7% of households had catastrophic health expenditure, with 32.9% having incurred distress financing. Multivariate analysis revealed being below poverty line, hospitalization in private healthcare facility, and presence of co-morbid conditions as significant determinants of catastrophic health expenditure. Conclusion High levels of catastrophic health expenditure and distress financing revealed by the study have unveiled major unaddressed challenges in the road to universal health coverage.
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Affiliation(s)
- Ronnie Thomas
- Department of Community Medicine, Government Medical College Kottayam, Kottayam, Kerala, India
- Correspondence: Ronnie Thomas, Department of Community Medicine, Government Medical College Kottayam, Kottayam, Kerala, India, Tel +91 9947014747, Email
| | - Quincy Mariam Jacob
- Department of Community Medicine, Government Medical College Kottayam, Kottayam, Kerala, India
| | - Sharon Raj Eliza
- Department of Community Medicine, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India
| | - Malathi Mini
- Department of Community Medicine, Government Medical College Kottayam, Kottayam, Kerala, India
| | - Jobinse Jose
- Department of Community Medicine, Kasturba Medical College, Mangalore, India
| | - Sobha A
- Department of Community Medicine, Government Medical College Kottayam, Kottayam, Kerala, India
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