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Sanuade OA, Kushitor MK, Awuah RB, Asante PY, Agyemang C, de-Graft Aikins A. Lay knowledge of cardiovascular disease and risk factors in three communities in Accra, Ghana: a cross-sectional survey. BMJ Open 2021; 11:e049451. [PMID: 34907046 PMCID: PMC8671941 DOI: 10.1136/bmjopen-2021-049451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 11/05/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Cardiovascular disease is a major cause of morbidity and mortality in Ghana, and urban poor communities are disproportionately affected. Research has shown that knowledge of cardiovascular disease (CVD) is the first step to risk reduction. This study examines knowledge of CVD and risk factors and determinants of CVD knowledge in three urban poor communities in Accra, Ghana. METHODS Using the Cardiovascular Disease Risk Factors Knowledge Level Scale, which has been validated in Ghana, we conducted a cross-sectional survey with 775 respondents aged 15-59 years. CVD knowledge was computed as a continuous variable based on correct answers to 27 questions, and each correct response was assigned one point. Linear regression was used to determine the factors associated with CVD knowledge. RESULTS The mean age of the participants was 30.3±10.8 years and the mean knowledge score was 19.3±4.8. About one-fifth of participants were living with chronic diseases. Overall, 71.1% had good CVD knowledge, and 28.9% had moderate or poor CVD knowledge. CVD knowledge was low in the symptoms and risk factor domains. A larger proportion received CVD knowledge from radio and television. The determinants of CVD knowledge included ethnicity, alcohol consumption, self-reported health and sources of CVD knowledge. CVD knowledge was highest among a minority Akan ethnic group, those who were current alcohol consumers and those who rated their health as very good/excellent, compared with their respective counterparts. CVD knowledge was significantly lower among those who received information from health workers and multiple sources. CONCLUSION This study underscores the need for health education programmes to promote practical knowledge on CVD symptoms, risks and treatment. We outline health systems and community-level barriers to good CVD knowledge and discuss the implications for developing context-specific and culturally congruent CVD primary prevention interventions.
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Affiliation(s)
- Olutobi Adekunle Sanuade
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | | | | | - Charles Agyemang
- Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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de-Graft Aikins A, Sanuade O, Baatiema L, Asante PY, Agyei F, Asah-Ayeh V, Okai JAO, Osei-Tutu A, Koram K. COVID-19, chronic conditions and structural poverty: A social psychological assessment of the needs of a marginalized community in Accra, Ghana. J Soc Polit Psych 2021. [DOI: 10.5964/jspp.7543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the African region COVID-19 infection and death rates are increasing (writing in May 2020), most deaths have occurred among individuals with chronic conditions, and poor communities face higher risks of infection and socio-economic insecurities. We assessed the psychosocial needs of a chronic illness support group in Accra, Ghana, within the context of their broader community. The community lives in structural poverty and has a complex burden of infectious and chronic non-communicable diseases (NCDs). Between March and May 2020, we conducted interviews, group discussions, and surveys, with members of the support group and their caregivers, frontline healthcare workers, and religious and community leaders. Data was analysed through the social psychology of participation framework. Community members understood COVID-19 as a new public health threat and drew on eclectic sources of information to make sense of this. Members of the support group had psychosocial and material needs: they were anxious about infection risk as well as money, food and access to NCD treatment. Some community members received government food packages during the lockdown period. This support ended after lockdown in April and while anti-poverty COVID policies have been unveiled they have yet to be implemented. We discuss the impact of these representational, relational and power dynamics on the community’s access to COVID-19 and NCD support. We argue that strategies to address immediate and post-COVID needs of vulnerable communities have to focus on the politics and practicalities of implementing existing rights-based policies that intersect health, poverty reduction and social protection.
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de-Graft Aikins A, Osei-Tutu A, Agyei F, Asante PY, Aboyinga H, Adjei A, Ahulu LD, Botchway I, Britwum M, Agyei Wiafe S, Edu-Ansah K, Nkrumah R, Ohenewaa E, Vogelsang JK, Ketor R. Competence in professional psychology practice in Ghana: Qualitative insights from practicing clinical health psychologists. J Health Psychol 2021; 26:1012-1025. [PMID: 31288572 DOI: 10.1177/1359105319859060] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Issues concerning competence of practicing psychologists have not been critically investigated in Ghana. This study used the three-dimensional cube model of core competencies as a framework to explore competencies of professional psychologists in active clinical health practice in Ghana. Sixteen clinical psychologists with 1 to 20 years of practicing experience were interviewed on adequacy of their graduate training for practice as well as maintaining post-training competence. The results suggested that training equipped the practitioners mainly for research and teaching but less so for clinical practice. Reflective practice was underdeveloped leading to critical challenges in emotional and cultural competencies. Structural support for continuous professional development was limited. Implications for professional psychology training, research and practice are discussed. This study is the first to explore competence issues in professional psychology practice in Ghana, and it contributes to the global discourse on continuous competence in psychology.
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Osei-Tutu A, Oti-Boadi M, Akosua Affram A, Dzokoto VA, Asante PY, Agyei F, Kenin A. Premarital Counseling Practices among Christian and Muslim Lay Counselors in Ghana. J Pastoral Care Counsel 2020; 74:203-211. [PMID: 32967548 DOI: 10.1177/1542305020916721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We examined premarital counseling services offered by Christian and Muslim lay counselors in Ghana. Participants including clergy, Islamic clerics, and laity practicing in four urban centers were interviewed. Thematic analysis showed that common issues covered include medical screening, beliefs and values, expectations, partner knowledge, roles and duties, sex, parenthood, financial management, communication, and conflicts. The findings offer important insight into religious premarital counseling in Ghana and contribute to the global literature on premarital counseling.
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Affiliation(s)
| | | | | | - Vivian A Dzokoto
- Department of African-American Studies, Virginia Commonwealth University, USA
| | | | - Francis Agyei
- Department of Psychology, University of Ghana, Ghana
| | - Abraham Kenin
- Department of Psychology, University of Ghana, Ghana
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de‐Graft Aikins A, Kushitor M, Kushitor SB, Sanuade O, Asante PY, Sakyi L, Agyei F, Koram K, Ogedegbe G. Building cardiovascular disease competence in an urban poor Ghanaian community: A social psychology of participation approach. J Community Appl Soc Psychol 2020. [DOI: 10.1002/casp.2447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ama de‐Graft Aikins
- Institute of Advanced StudiesUniversity College London London UK
- Regional Institute for Population StudiesUniversity of Ghana Accra Ghana
| | - Mawuli Kushitor
- Regional Institute for Population StudiesUniversity of Ghana Accra Ghana
| | | | - Olutobi Sanuade
- Institute of Advanced StudiesUniversity College London London UK
- Regional Institute for Population StudiesUniversity of Ghana Accra Ghana
| | | | - Lionel Sakyi
- Centre for Migration StudiesUniversity of Ghana Accra Ghana
| | - Francis Agyei
- Department of PsychologyUniversity of Ghana Accra Ghana
| | - Kwadwo Koram
- Noguchi Memorial Institute for Medical ResearchUniversity of Ghana Accra Ghana
| | - Gbenga Ogedegbe
- New York University School of MedicineNew York University New York NY USA
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Kushitor MK, Peterson MB, Asante PY, Dodoo ND, Boatemaa S, Awuah RB, Agyei F, Sakyi L, Dodoo FNA, de-Graft Aikins A. Community and individual sense of trust and psychological distress among the urban poor in Accra, Ghana. PLoS One 2018; 13:e0202818. [PMID: 30261067 PMCID: PMC6160026 DOI: 10.1371/journal.pone.0202818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 08/09/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mental health disorders present significant health challenges in populations in sub Saharan Africa especially in deprived urban poor contexts. Some studies have suggested that in collectivistic societies such as most African societies people can draw on social capital to attenuate the effect of community stressors on their mental health. Global studies suggest the effect of social capital on mental disorders such as psychological distress is mixed, and emerging studies on the psychosocial characteristics of collectivistic societies suggest that mistrust and suspicion sometimes deprive people of the benefit of social capital. In this study, we argue that trust which is often measured as a component of social capital has a more direct effect on reducing community stressors in such deprived communities. METHODS Data from the Urban Health and Poverty Survey (EDULINK Wave III) survey were used. The survey was conducted in 2013 in three urban poor communities in Accra: Agbogbloshie, James Town and Ussher Town. Psychological distress was measured with a symptomatic wellbeing scale. Participants' perceptions of their neighbours' willingness to trust, protect and assist others was used to measure community sense of trust. Participants' willingness to ask for and receive help from neighbours was used to measure personal sense of trust. Demographic factors were controlled for. The data were analyzed using descriptive and multivariate regressions. RESULTS The mean level of psychological distress among the residents was 25.5 (SD 5.5). Personal sense of trust was 8.2 (SD 2.0), and that of community sense of trust was 7.5 (SD 2.8). While community level trust was not significant, personal sense of trust significantly reduced psychological distress (B = -.2016728, t = -2.59, p < 0.010). The other factors associated with psychological distress in this model were perceived economic standing, education and locality of residence. CONCLUSION This study presents evidence that more trusting individuals are significantly less likely to be psychologically distressed within deprived urban communities in Accra. Positive intra and inter individual level variables such as personal level trust and perceived relative economic standing significantly attenuated the effect of psychological distress in communities with high level neighbourhood disorder in Accra.
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Affiliation(s)
- Mawuli K. Kushitor
- Regional Institute for Population Studies (RIPS), University of Ghana, Accra, Ghana
| | - Maame B. Peterson
- Regional Institute for Population Studies (RIPS), University of Ghana, Accra, Ghana
| | | | - Naa Dodua Dodoo
- Regional Institute for Population Studies (RIPS), University of Ghana, Accra, Ghana
| | - Sandra Boatemaa
- Regional Institute for Population Studies (RIPS), University of Ghana, Accra, Ghana
| | | | - Francis Agyei
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Lionel Sakyi
- Centre for Migration Studies, University of Ghana, Accra, Ghana
| | - F. Nii-Amoo Dodoo
- Regional Institute for Population Studies (RIPS), University of Ghana, Accra, Ghana
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies (RIPS), University of Ghana, Accra, Ghana
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Quarshie ENB, Peprah J, Asante PY, Verstraaten-Bortier M, Abbey EA, Agyei F. “It was touching”: Experiences and views of students in the June 3 flood and fire disaster relief response volunteerism in Accra, Ghana. Cogent Psychology 2018. [DOI: 10.1080/23311908.2018.1489481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Emmanuel Nii-Boye Quarshie
- Department of Psychology, School of Social Sciences, University of Ghana, Legon, Accra, Ghana
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Jennifer Peprah
- Department of Psychology, School of Social Sciences, University of Ghana, Legon, Accra, Ghana
| | - Paapa Yaw Asante
- Department of Psychology, School of Social Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Elizabeth Anorkor Abbey
- Department of Psychology, School of Social Sciences, University of Ghana, Legon, Accra, Ghana
| | - Francis Agyei
- Department of Psychology, School of Social Sciences, University of Ghana, Legon, Accra, Ghana
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Awuah RB, Asante PY, Sakyi L, Biney AAE, Kushitor MK, Agyei F, de-Graft Aikins A. Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana. Malar J 2018; 17:168. [PMID: 29661191 PMCID: PMC5902882 DOI: 10.1186/s12936-018-2311-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 04/05/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana. METHODS This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15-59 years for men and 15-49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria. RESULTS Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment. CONCLUSIONS The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty.
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Affiliation(s)
| | | | - Lionel Sakyi
- Centre for Migration Studies, University of Ghana, Accra, Ghana
| | - Adriana A E Biney
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | | | - Francis Agyei
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana.
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