Abstract
BackgroundInsights into the characteristics of treatment seekers for lifestyle changes and treatment preferences are necessary for intervention planning.AimTo compile a profile of treatment-seeking obese patients with non-communicable diseases (NCDs) or NCD risk factors and to compare patients who choose group-based (facility-based therapeutic group [FBTG]) versus usual care (individual consultations) treatment.SettingA primary healthcare facility in Cape Town, South Africa.MethodsOne hundred and ninety-three patients were recruited in this cross-sectional study. Ninety six chose FBTG while 97 chose usual care. A questionnaire, the hospital database and patients’ folders were used to collect data. Weight, height and waist circumference were measured. STATA 11.0 was used for descriptive statistics and to compare the two groups.ResultsThe subjects’ mean age was 50.4 years, 78% were women and of low education levels and income, and 41.5% had type 2 diabetes, 83.4% hypertension and 69.5% high cholesterol. Mean (s.d.) HbA1c was 9.1 (2.0)%, systolic BP 145.6 (21.0) mmHg, diastolic BP 84.5 (12.0) mmHg, cholesterol 5.4 (1.2) mmol/L), body mass indicator (BMI) 39.3 (7.3) kg/m2 and waist circumference 117 (12.6) cm). These figures were undesirable although pharmacological treatment for diabetes and hypertension was in place. Only 14% were physically active, while TV viewing was > 2h/day. Mean daily intake of fruit and vegetables (2.2 portions/day) was low while added sugar (5 teaspoons) and sugar-sweetened beverages (1.3 glasses) were high. Usual care patients had a higher smoking prevalence, HbA1c, number of NCD risk factors and refined carbohydrate intake, and a lower fruit and vegetable intake.ConclusionTreatment seekers were typically middle-aged, low income women with various modifiable and intermediate risk factors for NCDs. Patients choosing usual care could have more NCD risks.
Highlights
Insights into the characteristics of treatment seekers for lifestyle changes and treatment preferences are necessary for intervention planning
The present paper provides secondary analysis of crosssectional baseline data of a 6-month lifestyle intervention study where patients could choose to participate in either a 6-week facility-based therapeutic group (FBTG) programme or the usual care option available at a government district primary health care (PHC) hospital in Cape Town, South Africa
The reasons indicated by usual care choice patients for declining entrance into the FBTG intervention included work commitments (n = 37; 38.1%), preference for individual consultations (n = 14; 14.4%), transport problems (n = 9; 9.3%), family commitments (n = 5, 5.2%), medical problems (n = 2; 2.1%), demotivation (n = 1; 1.0%), out of area (n = 1; 1.0%) and time limitations (n=1; 1.0%)
Summary
Insights into the characteristics of treatment seekers for lifestyle changes and treatment preferences are necessary for intervention planning. Research indicates that socio-economic, cultural, political and environmental determinants, including population aging, globalisation, urbanisation and the accompanied nutrition transition contribute to the increase in NCDs in developing countries.[3,5,6,7] The presence of NCDs and numerous risk factors have been found to be higher in population groups with low income and low educational attainment in both low-middle income and high-income countries.[5,8] It has been reported that individuals living in urban environments in South Africa have a high prevalence of modifiable or behavioural risk factors such as an unhealthy diet, physical inactivity, smoking and excessive alcohol intake.[3,6,9] These modifiable risk factors, together with the presence of non-modifiable risk factors such as age, genetic predisposition, gender and race, result in the development over time of intermediate risk factors such as obesity, high blood pressure, high blood glucose and cholesterol.[10] http://www.phcfm.org
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