title: Development and evaluation of a patient centered cardiovascular health education program for insured patients in rural Nigeria (QUICK - II).
abstract: BACKGROUND
  In Sub Saharan Africa, the incidence of hypertension and other modifiable cardiovascular risk factors is growing rapidly. Poor adherence to prescribed prevention and treatment regimens by patients can compromise treatment outcomes. Patient-centered cardiovascular health education is likely to improve shortcomings in adherence. This paper describes a study that aims to develop a cardiovascular health education program for patients participating in a subsidized insurance plan in Nigeria and to evaluate the applicability and effectiveness in patients at increased risk for cardiovascular disease.
  
  
  METHODS
  
  
  
  METHODS
  The study has two parts. Part 1 will develop a cardiovascular health education program, using qualitative interviews with stakeholders. Part 2 will evaluate the effectiveness of the program in patients, using a prospective (pre-post) observational design.
  
  
  METHODS
  A rural primary health center in Kwara State, Nigeria.
  
  
  METHODS
  For part 1: 40 patients, 10 healthcare professionals, and 5 insurance managers. For part 2: 150 patients with uncontrolled hypertension or other cardiovascular risk factors after one year of treatment.
  
  
  METHODS
  Part 2: patient-centered cardiovascular health education program.
  
  
  METHODS
  Part 1: Semi-structured interviews to identify stakeholder perspectives. Part 2: Pre- and post-intervention assessments including patients' demographic and socioeconomic data, blood pressure, body mass index and self-reporting measures on medication adherence and perception of care. Feasibility of the intervention will be measured using process data.
  
  
  RESULTS
  For program development (part 1): overview of healthcare professionals' perceptions on barriers and facilitators to care, protocol for patient education, and protocol implementation plan.For program evaluation (part 2): changes in patients' scores on adherence to medication and life style changes, blood pressure, and other physiological and self-reporting measures at six months past baseline.
  
  
  METHODS
  Part 1: content analytic technique utilizing MAXQDA software. Part 2: univariate and multilevel analysis to assess outcomes of intervention.
  
  
  CONCLUSIONS
  Diligent implementation of patient-centered education should enhance adherence to cardiovascular disease prevention and management programs in low income countries.
  
  
  BACKGROUND
  ISRCTN47894401.
authors.affiliation: Dept of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, 1105 BM, The Netherlands. A.O.Odusola@amc.uva.nl
authors.forename: Aina Olufemi
authors.initials: AO
authors.lastname: Odusola
authors.forename: Marleen
authors.initials: M
authors.lastname: Hendriks
authors.forename: Constance
authors.initials: C
authors.lastname: Schultsz
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
authors.forename: Joep
authors.initials: J
authors.lastname: Lange
authors.forename: Akin
authors.initials: A
authors.lastname: Osibogun
authors.forename: Tanimola
authors.initials: T
authors.lastname: Akande
authors.forename: Shade
authors.initials: S
authors.lastname: Alli
authors.forename: Peju
authors.initials: P
authors.lastname: Adenusi
authors.forename: Kayode
authors.initials: K
authors.lastname: Agbede
authors.forename: Joke
authors.initials: J
authors.lastname: Haafkens
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D010353:Patient Education as Topic / Q000379:methods*; D018802:Patient-Centered Care / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D012107:Research Design; D012307:Risk Factors; D019035:Rural Health Services / Q000458:organization & administration*; D055815:Young Adult