Towards the Development of an Intervention to Address Social Determinants of Non-Communicable Disease in Kerala, India: A Mixed Methods Study
Authors
Martin Webber
International Centre for Mental Health Social Research, Department of Social Policy and Social Work, University of York, York YO10 5DD, UK; [email protected]
Jacques Joubert
Department of Neurology, St Vincent’s Hospital Melbourne, VIC 3065, Australia; [email protected]
Meredith Fendt-Newlin
International Centre for Mental Health Social Research, Department of Social Policy and Social Work, University of York, York YO10 5DD, UK; [email protected]
Lynette Joubert
Department of Social Work, Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia; [email protected]
Keywords:
cardiovascular disease, hypertension, diabetes, social risk, social intervention, social capital, social support, theory of change
Abstract
In India, cardiovascular disease (CVD), with hypertension as its foremost risk factor, has the highest prevalence rate of non-communicable diseases (NCDs) and a rising mortality. Previous research has found a clustering of behavioural and social risks pertaining to NCDs, though the latter are infrequently addressed in public health interventions in India. This paper reaches toward the development of a social intervention to address social determinants of NCD relating to hypertension and diabetes. We used Theory of Change (ToC) as a theoretical approach to programme design. Mixed methods were used, including qualitative interviews with community members (n = 20), Accredited Social Health Activists (n = 6) and health professionals (n = 8), and a stakeholder workshop (n = 5 participants). The recruitment of participants from one local area in Kerala enabled us to map service provision and gain a holistic understanding of how to utilise the existing workforce to target social risk factors. The findings suggest that social interventions need to focus on ensuring health behaviour information reaches all parts of the community, and that those with more social risk factors are identified and supported to engage with treatment. Further research is required to test the resulting intervention model.
Keywords: cardiovascular disease, hypertension, diabetes, social risk, social intervention, social capital, social support, theory of change
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