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Calvert C, Kolkenbeck-Ruh A, Crouch SH, Soepnel LM, Ware LJ. Reliability, usability and identified need for home-based cardiometabolic health self-assessment during the COVID-19 pandemic in Soweto, South Africa. Sci Rep 2022; 12:7158. [PMID: 35505062 PMCID: PMC9062861 DOI: 10.1038/s41598-022-11072-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
A major obstacle to tackling the growing burden of chronic disease in South Africa is lack of testing, particularly where individuals face multiple barriers to accessing health services. We conducted a pilot study to evaluate a cardiometabolic self-measurement kit, including assessment of blood pressure, obesity and urine analysis, amongst adults in Soweto, South Africa. Participants (N = 94) were recruited by researchers during community health screening and were provided with a home test kit including a tablet with self-measurement instructions. The participants entered their results on the tablet and, on completion, the researcher immediately repeated the measurements. We interviewed 10% of participants to understand their experience and views of the kits. Concordance correlation coefficients ranged from 0.78 for waist circumference to 0.93 for height, while the overall percentage agreement ranged from 80.5% for both urine protein and urine glucose testing to 91.4% for the identification of central obesity (ratio of waist circumference to height of ≥ 0.5). Participants saw the need for self-testing and found the process for the most part simple, though urine testing and height self-assessment presented some challenges. This pilot study suggests that self-assessment at home has the potential to facilitate the identification of individuals at risk for cardiometabolic disease in low-income settings, adding to a growing body of evidence on the use of self-testing in disease prevention and detection. However, we would not recommend self-testing for urine glucose and protein without further study.
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Affiliation(s)
- Clara Calvert
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK.
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
| | - Andrea Kolkenbeck-Ruh
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of Witwatersrand, Johannesburg, South Africa
| | - Simone H Crouch
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of Witwatersrand, Johannesburg, South Africa
| | - Larske M Soepnel
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of Witwatersrand, Johannesburg, South Africa
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lisa J Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of Witwatersrand, Johannesburg, South Africa
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Díaz JL, Codern-Bové N, Zomeño MD, Lassale C, Schröder H, Grau M. Quantitative and qualitative evaluation of the COMPASS mobile app: a citizen science project. Inform Health Soc Care 2021; 46:412-424. [PMID: 33847218 DOI: 10.1080/17538157.2021.1902332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To evaluate the usability of the COMPASS application with mixed-methodology, using a citizen science approach. Parents/tutors of 10-11 years old children attending a primary school in Barcelona, Spain, were invited to take part in the study. We conducted semi-structured interviews on a subset (n = 7) of participants, two weeks after using the app for the first time. A list of suggestions of improvement was extracted from the interviews. The System Usability Scale (SUS, range 0-100) was administered to all participants before and after the improvements were implemented. We provide both a quantitative analysis (t-test of change in SUS scores) and a qualitative thematic analysis of the interviews. A total of 22 participants were included in the study. The mean score before implementation of changes was 68.5 (Standard deviation, SD = 11.1), and improved to 73.1 (10.5) (p-value = 0.025). Regarding the qualitative assessment, we obtained 24 codes and grouped them into 3 categories. It uncovered problems in the installation phase and the main barriers to use: lack of time and the need for the app to evolve. The new version of COMPASS, improved by taking into account the participants' comments and suggestions, was more usable than the initial version.
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Affiliation(s)
- Jorge Luis Díaz
- Cardiovascular Epidemiology and Genetics, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain.,Docent Unit of Preventive Medicine and Public Health Mar Health Park, Pompeu-Fabra University - Barcelona Public Health Agency, Spain
| | - Núria Codern-Bové
- Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona, Terrassa, Spain
| | - Maria-Dolors Zomeño
- Cardiovascular Risk and Nutrition, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain.,Consortium for Biomedical Research in Obesity and Nutrition (CIBERobn), Barcelona, Spain.,School of Health Sciences, Blanquerna-Ramon Llul University, Barcelona, Spain
| | - Camille Lassale
- Cardiovascular Risk and Nutrition, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain.,Consortium for Biomedical Research in Obesity and Nutrition (CIBERobn), Barcelona, Spain.,Department of Behavioural Science and Health, University College London, London, UK
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), Spain
| | - María Grau
- Cardiovascular Epidemiology and Genetics, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), Spain.,Serra-Húnter Fellow, Department of Medicine, University of Barcelona, Barcelona, Spain
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Barroso M, Zomeño MD, Díaz JL, Pérez S, Martí-Lluch R, Cordón F, Ramos R, Cabezas C, Salvador G, Castell C, Schröder H, Grau M. Efficacy of tailored recommendations to promote healthy lifestyles: a post hoc analysis of a randomized controlled trial. Transl Behav Med 2021; 11:1548-1557. [PMID: 33837787 DOI: 10.1093/tbm/ibab035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Prevention is the key to stopping the ravages of cardiovascular diseases, the main cause of death worldwide. The objective was to analyze the efficacy of tailored recommendations to promote healthy lifestyles. Parallel-arm randomized controlled trial with 1 year follow-up. Individuals aged 35-74 years from Girona (Spain) randomly selected from a population with no cardiovascular diseases at baseline were included. Participants in the intervention group received a brochure with tailored healthy choices according to the individual risk profile and a trained nurse explained all recommendations in detail in a 30 min consultation. One year changes in smoking, Mediterranean diet adherence, physical activity, and weight were analyzed with McNemar, Student's t, Wilcoxon, and Fisher exact tests according to an intention-to-treat strategy. Of 955 individuals (52.3% women; mean age 50 [±10] years) randomly allocated to the intervention or control group, one participant in each group presented a cardiovascular event and 768 (81%) were reexamined at 1 year follow-up. The prevalence of nonsmokers increased in both the intervention and control groups (78.1%-82.5%, p = <.001, and 76.7% to 78.8%, p = .015, respectively); however, significance persisted only in the intervention group when stratified by sex, age group, and educational level. Adherence to a Mediterranean diet increased in the intervention group (22.3%-26.5%, p = .048). In conclusion, a brief personalized intervention with science-based recommendations according to individual risk profiles appears to improve healthy lifestyles, particularly nonsmoking and adherence to a Mediterranean diet. This promising intervention system offers evidence-based recommendations to develop healthy lifestyles.
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Affiliation(s)
- María Barroso
- Cardiovascular Epidemiology and Genetics Research Group, IMIM-Hospital del Mar Research Institute, 08003 Barcelona, Spain.,Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, School of Medicine, Autonomous University of Barcelona, 08193 Barcelona, Spain.,Eastfield Health, Ashburton 7700, New Zealand
| | - M Dolors Zomeño
- Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain.,School of Health Sciences, Blanquerna-Ramon Llull University, 08022 Barcelona, Spain
| | - Jorge L Díaz
- Cardiovascular Epidemiology and Genetics Research Group, IMIM-Hospital del Mar Research Institute, 08003 Barcelona, Spain
| | - Silvia Pérez
- Regicor Research Group, IMIM-Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain.,Consortium for Biomedical Research in Cardiovascular Disease (CIBERCV), 08003 Barcelona, Spain
| | - Ruth Martí-Lluch
- Unitat de Suport a la Recerca de Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, 17002 Girona, Spain
| | - Ferran Cordón
- Centre d'Atenció Primària Montilivi, Direcció d'Atenció Primària Girona, Institut Català de la Salut, 17003 Girona, Spain
| | - Rafel Ramos
- Unitat de Suport a la Recerca de Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, 17002 Girona, Spain.,Department of Medical Sciences, School of Medicine, University of Girona, 17071 Girona, Spain.,Girona Biomedical Research Institute, 17190 Girona, Spain
| | | | | | - Conxa Castell
- Catalan Agency of Public Health, 08005 Barcelona, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 08003 Barcelona, Spain
| | - María Grau
- Cardiovascular Epidemiology and Genetics Research Group, IMIM-Hospital del Mar Research Institute, 08003 Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 08003 Barcelona, Spain.,Serra-Húnter Fellow, Department of Medicine, University of Barcelona, #143 Casanova St., 08036 Barcelona, Spain
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Barroso M, Baena-Díez JM, Muñoz-Aguayo D, Díaz JL, Schröder H, Grau M. Reference ranges of glycated hemoglobin (HbA1c) in capillary blood in the Spanish population. Prim Care Diabetes 2020; 14:768-771. [PMID: 31836306 DOI: 10.1016/j.pcd.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/07/2019] [Accepted: 11/17/2019] [Indexed: 11/16/2022]
Abstract
Cross-sectional analysis describing HbA1c reference values by sex and age in a randomly selected Mediterranean general population sample. Using two methods, Point-of-Care systems and centralized laboratory, results show that HbA1c values increase with age. Almost half of the sample aged 65 years or older had median values >5.7% (prediabetes cut-off point).
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Affiliation(s)
- María Barroso
- Cardiovascular Epidemiology and Genetics, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain; Gornal Primary Care Centre, IDIAP Jordi Gol, Catalan Institute of Health (ICS), L'Hospitalet de Llobregat, Spain; PhD Programme in Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Autonomous University of Barcelona, Spain
| | - Jose Miguel Baena-Díez
- La Marina Primary Care Centre, IDIAP Jordi Gol, Catalan Institute of Health (ICS), Barcelona, Spain
| | - Daniel Muñoz-Aguayo
- Cardiovascular Risk and Nutrition, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain; Consortium for Biomedical Research in Obesity and Nutrition (CIBERobn), Barcelona, Spain
| | - Jorge Luis Díaz
- Cardiovascular Epidemiology and Genetics, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain; Teaching Unit of Preventive Medicine and Public Health Mar Health Park, Pompeu-Fabra University, Barcelona Public Health Agency, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), Spain
| | - María Grau
- Cardiovascular Epidemiology and Genetics, IMIM - Hospital del Mar Medical Research Institute, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), Spain; Department of Medicine, University of Barcelona, Spain.
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Barroso M, Zomeño MD, Díaz JL, Pérez-Fernández S, Martí-Lluch R, Cordón F, Ramos R, Cabezas C, Salvador G, Castell C, Schröder H, Grau M. Control of cardiovascular risk factors with tailored recommendations: A randomized controlled trial. Prev Med 2020; 141:106302. [PMID: 33144141 DOI: 10.1016/j.ypmed.2020.106302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
This study analyzed the efficacy of tailored recommendations to control cardiovascular risk factors at 1-year follow-up in a population-based randomized controlled trial in individuals aged 35-74 years with no history of cardiovascular disease at baseline. Total, low-density lipoprotein (LDL), and high-density lipoprotein cholesterol and systolic and diastolic blood pressure (BP) were measured at baseline and at 1-year follow-up. The primary outcome was the quantitative change in total cholesterol. To estimate the differences within and between groups, McNemar and Student t-tests were applied according to an intention-to-treat strategy. We enrolled 955 individuals [52.3% women; mean age, 50 years (standard deviation 10)]. Finally, 1 participant in each group presented a cardiovascular event and 768 were reexamined at 1-year follow-up. Intervention and control groups showed significant increases in total cholesterol [5.49 (standard deviation 1.02) to 5.56 (1.06) mmol/L and 5.34 (0.94) to 5.43 (0.93) mmol/L, respectively]. Men in the intervention group showed significant decreases in systolic and diastolic BP [117.2 (14.6) to 115.6 mmHg (14.1) and 77.9 (9.7) to 76.5 mmHg (9.7), respectively]; no changes were found in the rates of total cholesterol <5.2 mmol/L and LDL cholesterol <3.0 mmol/L. In the control group, both values were significantly decreased (43.5 to 36.4% and 26.4 to 20.8%, respectively) in men. In the stratified analysis, women showed no differences in any of the outcomes. In conclusion, an intervention with tailored recommendations increased mean total cholesterol values. The intervention effect was higher in men who maintained blood lipids at optimal levels and had decreased BP values.
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Affiliation(s)
- María Barroso
- Cardiovascular Epidemiology and Genetics Research Group, IMIM-Hospital del Mar Research Institute, Barcelona, Spain; Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, School of Medicine, Autonomous University of Barcelona, Spain; Eastfield Health, Ashburton, New Zealand
| | - M Dolors Zomeño
- Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; School of Health Sciences, Blanquerna-Ramon Llull University, Barcelona, Spain
| | - Jorge L Díaz
- Cardiovascular Epidemiology and Genetics Research Group, IMIM-Hospital del Mar Research Institute, Barcelona, Spain; Docent Unit Preventive Medicine and Public Health Parc de Salut Mar, Barcelona Public Health Agency, Pompeu-Fabra University, Barcelona, Spain
| | - Silvia Pérez-Fernández
- Regicor Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Consortium for Biomedical Research in Cardiovascular Disease (CIBERCV), Barcelona, Spain
| | | | - Ferran Cordón
- Primary Care Services, Catalan Institute of Health, Girona, Catalunya, Spain; Department of Medical Sciences, School of Medicine, University of Girona, Spain
| | - Rafel Ramos
- ISV Girona, IDIAP Jordi Gol, Girona, Catalunya, Spain; Department of Medical Sciences, School of Medicine, University of Girona, Spain; Girona Biomedical Research Institute, Girona, Spain
| | | | | | | | - Helmut Schröder
- Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - María Grau
- Cardiovascular Epidemiology and Genetics Research Group, IMIM-Hospital del Mar Research Institute, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Serra Húnter Fellow, Department of Medicine, University of Barcelona, Barcelona, Spain.
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