Abstract
Aim
This study aims to determine the knowledge, attitudes, and practices (KAP) of community health workers (CHWs) working in the eastern region of São Paulo, Brazil, regarding noncommunicable diseases (NCDs) and their risk factors, as a preliminary step toward training optimization.
Subject and methods
We conducted an online cross-sectional survey study with KAP questions on NCD risk factors, cardiovascular diseases (CVD), diabetes, chronic obstructive pulmonary disease (COPD), and cancer. CHWs working full-time in family health teams were invited to participate in the months of January and February 2019. Descriptive analyses were performed for all survey questions, and knowledge scores were calculated from the sum of correct answers to the knowledge questions.
Results
The survey was completed by 1071 CHWs (85% response rate). Most respondents were women and had less than five years of work experience. The mean overall knowledge score was 62%. The highest score was obtained for the CVD category (80.2%), and the lowest scores in the COPD (28%) and cervical cancer (32.9%) categories. The majority of CHWs considered diabetes as the most important NCD in their communities. At the practice level, CHWs reported being the most confident about their counseling on cervical and breast cancer screening, and the least confident about colon cancer screening.
Conclusion
Several knowledge and practice gaps across different NCDs have been identified, which can inform the optimization of CHWs’ training and clinical activities in order to improve their effectiveness in preventing and managing NCDs in the Brazilian context.
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Availability of data and material
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Code availability
Not applicable.
Abbreviations
- APS:
-
Atenção Primária à Saúde Santa Marcelina or Santa Marcelina Primary Care Network
- CHWs:
-
Community Health Workers
- COPD:
-
Chronic obstructive pulmonary disease
- CRC:
-
Colorectal cancer
- CVDs:
-
Cardiovascular diseases
- FHTs:
-
Family health teams
- KAP:
-
Knowledge, attitudes and practices
- LMICs:
-
Low- and middle-income countries
- NCDs:
-
Noncommunicable diseases
- PHC:
-
Primary health care
- WHO:
-
World Health Organization
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Acknowledgments
The authors gratefully acknowledge the administrative, logistical, and translation support received from Sister Monique Bourget, Dr. José Carlos Arrojo, Dr. Alex Cassenote, Dr. Bruno Castro, Renan Gussen, Adriana Marega, Dr. Martim Elviro Medeiros, Gilson Parra, Dr. Morris Souza Pimenta, and Christian Ruchon that have made this project possible. We also want to thank Dr. Jeannie Haggerty for her expertise in survey methods and advice on the survey instrument development.
Funding
CJ received funding from the McGill Global Health Programs (Global Health Travel Awards for Postgraduate Medical Residents) and the McGill Graduate and Postdoctoral Studies (Grad Mobility Award), which supported travel expenses to Brazil for the project development and data collection.
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Contributions
CJ, TS, and YB contributed to the study conception and design. Material preparation and data collection was performed primarily by CJ, with logistical assistance from JSM, SSF, and WN. Quantitative data analysis was performed by CJ and TS. The first draft of the manuscript was written by CJ, and all authors reviewed and commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Ethics approval
The study protocol was approved by the McGill Faculty of Medicine Institutional Review Board (Study Number A05-B26-18A), the Hospital of Santa Marcelina Ethics Committee (Study Number 03653918.9.0000.0066), and the São Paulo Municipal Secretary of Health Ethics Committee (Study Number 03653918.9.3002.0086).
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Informed consent was obtained from all individual participants included in the study.
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Not applicable.
Competing interests
JSM, SSF, and WN receive salary from the Santa Marcelina Health as healthcare professionals working within this organization. They did not contribute to the study conception and design, nor the data analysis and interpretation. The other authors do not have any competing interest to declare in relation to this manuscript.
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Ji, C., Schuster, T., Martins, J.S. et al. Knowledge, attitudes, and practices of community health workers regarding noncommunicable diseases in São Paulo, Brazil: a cross-sectional study. J Public Health (Berl.) (2023). https://doi.org/10.1007/s10389-023-02079-w
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DOI: https://doi.org/10.1007/s10389-023-02079-w