TY - JOUR
T1 - Facilitators and barriers to NCD prevention in Pakistanis-invincibility or inevitability
T2 - A qualitative research study
AU - Gowani, Ambreen
AU - Ahmed, Hafiz Imtiaz
AU - Khalid, Wardah
AU - Muqeet, Abdul
AU - Abdullah, Saad
AU - Khoja, Shariq
AU - Kamal, Ayeesha Kamran
N1 - Funding Information:
This project is a joint effort between the following partners: Aga Khan University, AKDN eHealth Resource Center, and Tech4Life Enterprises. We would like to acknowledge the time and cooperation of the families who contributed to this study. They are a source of inspiration and courage. This study has been made possible by the following Grand Challenges Canada, Bold Ideas with Big Impact, Grant award entitled, “One Stop for Strokes—realize the possibility, in your hands. Fighting the stroke epidemic in developing countries by enabling risk detection and empowering knowledge for action to decrease stroke death and disability”Grand Challenges Canada Grant Number 0432-01, Rising Stars in Global Health Round 5, Phase I Program.
Funding Information:
1 Stroke Service Research Nurse, Aga Khan University, Karachi, Pakistan. 2Technology Development, Aga Khan Development Network, eHealth Resource Center, Karachi, Pakistan. 3 Fogarty Cerebrovascular Research Fellow, The International Cerebrovascular Translational Clinical Research Training Program (Fogarty International Center, National Institutes of Health), Aga Khan University, Karachi, Pakistan. 4 eHealth Innovation, Global, Aga Khan Development Network, eHealth Resource Center, Karachi, Pakistan. 5Tech4Life Enterprises, Karachi, Pakistan. 6 Tech4Life Enterprises, Canada, and Technical Advisor-Evidence, Capacity and Policy mHealth Alliance, United Nations Foundation, Washington, USA. 7 Section of Neurology, Department of Medicine, Stroke Fellowship Program, International Cerebrovascular Translational Clinical Research Training Program, Fogarty International Center and the National Institute of Neurologic Disorders and Stroke, Aga Khan University, Stadium Road, Karachi 74800, Pakistan.
Publisher Copyright:
© 2016 The Author(s).
PY - 2016
Y1 - 2016
N2 - Background: Non-communicable diseases (NCD) are the leading causes of death globally. In Pakistan, they are among the top ten causes of mortality, especially in the productive age group (30-69 years). Evidence suggests that health perceptions and beliefs strongly influence the health behavior of an individual. We performed focus group interviews to delineate the same so as to design the user interface of a non-invasive stroke risk monitoring device. Methods: It was a qualitative study, designed to explore how health perceptions and beliefs influence behavior for NCD prevention. Four focus group discussions (FGD) were conducted with 30 stable participants who had diabetes mellitus, ischemic heart disease, blood pressure, and stroke. The data was collected using a semi-structured interview guide designed to explore participants' perceptions of their illnesses, self-management behaviors and factors affecting them. The interviews were transcribed and content analysis was done using steps of content analysis by Morse and Niehaus [10]. Results: Medication adherence, self-monitoring of blood sugars and blood pressures, and medical help seeking were the commonly performed self-management behaviors by the participants. Personal experience of illness, familial inheritance of disease, education and fear of premature death when life responsibilities were unfulfilled, emerged as strong facilitators of self-management behaviors. A sense of personal invincibility, Fatalism or inevitability, lack of personal threat realization, limited knowledge, inadequate health education, health care and financial constraints appeared as key barriers to the self-management of chronic disease in participants. Conclusions: Behavioural interventional messaging will have to engender a sense of personal vulnerability and yet empower self-efficacy solutions at the individual level to deal with both invincibility and inevitability barriers to adoption of healthy behavior.
AB - Background: Non-communicable diseases (NCD) are the leading causes of death globally. In Pakistan, they are among the top ten causes of mortality, especially in the productive age group (30-69 years). Evidence suggests that health perceptions and beliefs strongly influence the health behavior of an individual. We performed focus group interviews to delineate the same so as to design the user interface of a non-invasive stroke risk monitoring device. Methods: It was a qualitative study, designed to explore how health perceptions and beliefs influence behavior for NCD prevention. Four focus group discussions (FGD) were conducted with 30 stable participants who had diabetes mellitus, ischemic heart disease, blood pressure, and stroke. The data was collected using a semi-structured interview guide designed to explore participants' perceptions of their illnesses, self-management behaviors and factors affecting them. The interviews were transcribed and content analysis was done using steps of content analysis by Morse and Niehaus [10]. Results: Medication adherence, self-monitoring of blood sugars and blood pressures, and medical help seeking were the commonly performed self-management behaviors by the participants. Personal experience of illness, familial inheritance of disease, education and fear of premature death when life responsibilities were unfulfilled, emerged as strong facilitators of self-management behaviors. A sense of personal invincibility, Fatalism or inevitability, lack of personal threat realization, limited knowledge, inadequate health education, health care and financial constraints appeared as key barriers to the self-management of chronic disease in participants. Conclusions: Behavioural interventional messaging will have to engender a sense of personal vulnerability and yet empower self-efficacy solutions at the individual level to deal with both invincibility and inevitability barriers to adoption of healthy behavior.
KW - Lower and middle income countries
KW - Non-communicable diseases
KW - Qualitative study
KW - Self-management
UR - http://www.scopus.com/inward/record.url?scp=85007413756&partnerID=8YFLogxK
U2 - 10.1186/s13104-016-2087-2
DO - 10.1186/s13104-016-2087-2
M3 - Article
C2 - 27215828
AN - SCOPUS:85007413756
SN - 1756-0500
VL - 9
JO - BMC Research Notes
JF - BMC Research Notes
IS - 1
M1 - 282
ER -
