Prevention Of Non-communicable Diseases Research Articles

Counseling and examination related to the prevention of hypertension and diabetes in the elderly

Aging brings various health challenges, including hypertension and diabetes mellitus, which can affect the quality of life of the elderly. This study aims to identify the prevalence of these two diseases in Kepatihan Village, Kaliwates District, Jember Regency, and evaluate the effectiveness of health education in managing them. Community service activities include initial examinations that show a high prevalence of hypertension and prediabetes among the elderly, with only a few having normal blood pressure and blood sugar levels. The program involves health examinations, disease prevention and control education, and re-examination two weeks after the education. The results showed that older adults with normal blood pressure increased from 3 to 8 people, and regular blood sugar levels increased from 5 to 21 people. A significant decrease in cases of prehypertension and diabetes indicates the success of the education in increasing participants' awareness and knowledge about managing their health. However, high initial health conditions and limited resources remain barriers. This program shows the effectiveness of education in reducing the prevalence of non-communicable diseases among the elderly but requires continued efforts to support more sustainable health improvements

Communication, education, and information on non-communicable diseases

Non-communicable diseases (NCDs) such as diabetes mellitus, hypertension, and heart disease continue to increase in Indonesia, threatening public health and adding to the country's economic burden. Efforts to control NCDs require an integrated approach, one of which is through community service programs that focus on communication, education, and information (KIE). This community service program aims to increase public awareness and knowledge about NCDs, especially diabetes mellitus, by involving various parties, including academics, health workers, and local communities. The methods used in this program include health counseling, campaigns through social media, and interactive training in various villages and sub-districts. The results of this program show a significant improvement in public understanding of risk factors, early signs, and NCD prevention measures. The active participation of the community in this activity also strengthens collective awareness about the importance of a healthy lifestyle and regular health checkups. This program has succeeded in having a positive impact on efforts to prevent and control NCDs in the community. The recommendations of this program include expanding the reach of KIE activities, wider use of information technology, and continuous collaboration between various sectors to create a healthier society.

Estimating the prevalence of select non-communicable diseases in Saudi Arabia using a population-based sample: econometric analysis with natural language processing.

Non-communicable diseases (NCDs) are a major public health challenge globally, including in Saudi Arabia. However, measuring the true extent of NCD prevalence has been hampered by a paucity of nationally representative epidemiological studies. Assess the prevalence of selected NCDs, using population-based electronic health records and applying novel analytical methods to identify cases of NCDs. Retrospective. A large healthcare network in Saudi Arabia. We included all beneficiaries aged 16 years or older (n=650 835[a]) and used the International Classification of Disease (ICD-10) codes, laboratory results, and associated medications to identify individuals with diabetes, obesity, hypertension, dyslipidemia, mental disorders, and injuries. For diabetes and hypertension, we used natural language processing (NLP) on clinical notes in the electronic health records. The prevalence of multimorbidity across age groups was also tabulated, and logistic regression was used to examine its association with glycemic control. The primary outcomes measured were the prevalence of diabetes, hypertension, and multimorbidity, and their association with glycemic control. 650 835 individuals aged 16 years or older. The study population was relatively young, with 41.2% aged between 26 and 45 years, and around two-thirds were married. The prevalence of diabetes and hypertension was 18.5% (95% CI: 18.5-18.7) and 13.0% (95% CI: 12.9-13.1), respectively. Approximately 26.7% (95% CI: 26.7-26.8) of the population had multimorbidity, with levels increasing to 62.9% for those aged 65 or older. Multimorbidity was associated with a four-fold increase in the likelihood of poor glycemic control. NLP analysis suggested that the prevalence of diabetes or hypertension may be underestimated by no more than 1.5%. The study suggests a higher prevalence of NCDs than earlier national estimates. Electronic health records with regular analysis provide an opportunity to estimate changes in the prevalence of NCDs in Saudi Arabia. Health policies and interventions are needed to address the high levels of multimorbidity, which adversely impact glycemic control. Retrospective design and reliance on electronic health records, which may not capture all cases of NCDs.

Development of Protocol for the Indian Council of Medical Research (ICMR) task force study to strengthen the implementation of National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) in tribal population.

Understanding the health culture of tribal community is important as health problems among tribal communities and their care is influenced by sociocultural factors, which will help in the implementation of health services. The conventional way of improving the access for the general populations may not suit the tribal populations owing to their distinct culture and owing to health systems factors as well. A stepwise process was followed for the development of a protocol to study to strengthen the implementation of National Programme for Prevention and Control of Non-Communicable Diseases. The study was planned to be carried out across six tribal districts of India. A detailed protocol was built around Implementation Research Logic Model, primarily as a method for planning, executing, reporting, and synthesizing the implementation.

Chronotype and lifestyle in the transition to adulthood: Exploring the role of sleep health and circadian misalignment

ObjectivesThe present study aimed at exploring the association between eveningness and lifestyle-related variables, that is, body mass index, alcohol, and cigarette consumption, in adults (18-40years), focusing on the possible moderator effect of age and the role of sleep disturbances and circadian misalignment (social jetlag). MethodsA web-based survey was administered to 437 participants, covering demographics, lifestyle-related variables, chronotype, sleep quality, and daytime sleepiness. A subset of 206 participants wore a wrist actigraph for a week, allowing the creation of a sleep health index within the RU-SATED framework. Regression analysis was used to investigate the associations between chronotype and lifestyle-related outcomes, accounting for social jetlag and sleep health; and to explore the lifestyle trajectories over time. ResultsEvening chronotypes showed higher body mass index levels, consumed more alcohol, and smoked more cigarettes than other circadian typologies, in particular after 25 years of age. Poor sleep health and social jetlag significantly contribute to explaining evening types smoking behavior, while not affecting body mass index levels. Social jetlag plays a more important role compared to sleep disturbances and eveningness in predicting more detrimental drinking and smoking behavior. ConclusionsParticipants who maintain the evening trait past the age of 25years are more prone to adopt an unhealthy lifestyle, especially if experiencing poor sleep health and circadian misalignment. Circadian preferences and sleep health should be considered when planning interventions aimed at promoting healthy lifestyles in adults aged 18-40years. Further investigations should explore the effect of modifications in lifestyle in the prevention of noncommunicable diseases.

Non-alcoholic fatty liver disease (NAFLD) integration into India's NCD program - Obstacles and solutions for the implementation of guidelines at the national level.

Individuals who have non-alcoholic fatty liver disease (NAFLD) are at high risk of metabolic comorbidities and can put a significant strain on healthcare systems. If not managed in a timely manner, NAFLD can lead to sustained healthcare costs, economic losses, and reduced health-related quality of life. In India, the Ministry of Health and Family Welfare recognized the need for a comprehensive approach to prevent NAFLD and integrated public health measures into the existing National Program for Prevention and Control of Non-Communicable Diseases (NP NCD). However, 3 years after the integration, there is no clear measure of the extent of implementation of this program, and the exact facilitators and barriers to implementing the program are yet to be determined. The next step toward providing comprehensive and effective healthcare services to those affected by NAFLD is the implementation of NAFLD guidelines under the NP NCD. The article emphasizes the importance of replacing old reporting formats with updated ones that incorporate NAFLD. It also highlights the need for healthcare personnel and community health workers to receive multiple trainings. While measuring waist circumference (WC) and identifying patients who need referral poses challenges, we can overcome them by updating the Non-Communicable Disease (NCD) application to include NAFLD, recording WC in registers, and using up-to-date reporting formats.

Drivers of Healthy Lifestyle Behaviors among Arable Crop Farmers: Evidence from Kwara State, Nigeria

Globally, a healthy lifestyle is important in maintaining the balance between man and the environment as well as the prevention and avoidance of Non-Communicable Diseases (NCDs) especially among rural dwellers in developing economies where the state of quality healthcare is in chaos. In theory, individuals are products of investments made in their health which are either health-promoting or health-damaging behavior. We causally identify the motives of healthy lifestyle practices among arable crop farmers in Kwara state, Nigeria using a cross-sectional survey. We found out that less than average of the arable crop farmers sampled practiced healthy lifestyles and the factors that strongly influenced the healthy lifestyle behavior of arable crop farmers were gender, age, education, farm size, farm income as well as distance to healthcare. A policy simulation illustrates that taking consideration of the socioeconomic characteristics that drive the practice of healthy lifestyles will improve the health status of the populace, especially the rural dwellers, and also avoid lifestyle-related diseases in the future.

Nursing outcomes and social support intervention for diabetes self-management: consensus study

Highlights Self-management of type 2 diabetes allows for better health outcomes, maintains independence, and improves quality of life for longer periods of time. Nursing interventions help professionals accurately assess the health status and outcomes of the target population while providing scientific evidence. The nursing professional is a significant source of social support in the self-management of diabetes mellitus. The outcomes achieved by patients are the most important indicators of quality in health care, allowing clarifying nursing knowledge and determining the effectiveness of care. Introduction: Diabetes mellitus is one of the most prevalent chronic noncommunicable diseases in the world. Objective: To validate by expert consensus the Nursing Outcomes Classification (NOC) self-management: diabetes (1619) and social support (1504), as well as to validate the intervention of social support for adults in the self-management of type 2 diabetes mellitus (DM2). Materials and Methods: A consensus study. Several phases were delimited for validation: the first was to validate the results and indicators; the second was to construct and validate the conceptual and operational definitions; and the magnitude of the selected indicators; and the third was to design and validate the intervention of social support for adults in the self-management of DM2. Results: 28 indicators were selected and validated by experts out of the 44 that make up the nursing outcome of self-management: diabetes, and 9 indicators out of the 12 that make up the social support outcome, both with a Content Validity Index (CVI) of 0.98. As for the intervention, a social support intervention was designed for the self-management of DM2, individualized, and made up of 4 sessions. The components of the intervention include generalities of DM2, healthy life habits, safe care, and emotional support. Discussion: Nursing professionals must evaluate people who experience diabetes, and their capacity for self-management and social support in order to provide appropriate interventions and evaluate their effectiveness. Conclusions: The study significantly evidenced the validation of the two nursing outcomes and their respective indicators, added to the conceptual and operational definitions, and their magnitude. How to cite this article: Garizábalo-Dávila Claudia Milena, Cañon-Montañez Wilson, Rodríguez-Acelas Alba Luz. Nursing Outcomes and Social Support Intervention for Diabetes Self-management: Consensus Study. Revista Cuidarte. 2024;15(3):e3742. https://doi.org/10.15649/cuidarte.3742

Evaluation of the Nutritional Knowledge in Relation to Secondary Prevention Among Doctors and Nurses in the Northern of Morocco: A Cross-Sectional Study.

Morocco is a country that has been experiencing an epidemiological and health transition characterized by a change in lifestyle and an increase in mortality for non-communicable diseases (NCDs). The objective of this study is to evaluate the nutritional knowledge in relation to secondary prevention of doctors and nurses working in the hospitaland primary healthcare centersin Morocco.Specific knowledge about nutrition for diabetes, for high blood pressure and high cholesterol, for functional colopathy, for iron deficiency anemia, for vitamin B12 deficiency, for overweight and for hyperuricemia or gout attack were evaluated. Cross-sectional exploratory study carried out between June and December 2022, using a self-administered questionnaire developed on the basis of similar studies and the several standardized nutrition guides. A random cluster survey included 238 nurses and 131 doctors working in health centers and 234 nurses and 54 doctors working in hospitals. Statistical analyses were carried out using SPSS version 21.0 software, the Kolmogorov-Smirnov test, the Mann Whitney test, and Spearmen's correlation. Multiple linear regression analysis was used to explore the most significant sociodemographic variables. Among the seven nutritional content areas assessed in this study, we found that among doctors, the nutrition axis for high blood pressure and high cholesterol had the median correct response score of (0.57 interquartile range (IQR) (0.28, 0.71)). The same for nurse, but with the lower scores ((0.28 IQR (0, 0.43)) , (0.28 IQR (0.07, 0.42)) respectively). Our results do not reveal any statistically significant association of the median of total score of answers of both health professionals (nurses or of doctors) with their gender (p=0.383). However, they were significantly associated with basic training (p<0.001), continuous training (p=0.002), receiving information on nutrition (p=0.018), and their age (p=0.016). In conclusion, this study highlighted the major gaps in the nutritional knowledge of doctors and nurses regarding secondary prevention of NCDs. However, they should undergo continuing nutrition education programs to ensure safe and sound nutritional advice not only to patients but also to the public.Furthermore, policymakers should devote systematic efforts to nutrition education during basic training in medical and nursing schools, which will provide doctors and nurses with adequate training.

Evaluating the Impact of a Clinical Breast Examination Screening Program within the IraPEN Project.

Breast cancer is a prevalent global cancer and a leading cause of mortality in developed countries. In 2015, Iran introduced the Package of Essential Noncommunicable Diseases (IraPEN) as a pilot project to tackle prevalent noncommunicable diseases, including breast cancer. However, there is limited research evaluating the implementation, costs, and outcomes of breast cancer screening within IraPEN. Therefore, this study aims to investigate the costs and outcomes of the clinical breast examination screening program in Isfahan from 2017 to 2020. This descriptive cost-outcome study utilized data from 450,876 individuals aged 30 to 69 who participated in clinical breast examination screening. The outcomes assessed in this program encompassed the number of participants, the number of individuals identified with symptoms, referrals to the next level of examination, the number of individuals undergoing mammography, recorded mammography results, and the number of cases of breast cancer identified. Direct costs were estimated, including personnel, infrastructure, equipment, and other related expenses. ‌The findings revealed that the direct costs of the breast cancer screening program in Isfahan between 2017 and 2020 were 310,514,608,558 Rials, equivalent to approximately 15,470,633 PPP$. These expenses led to the identification of 134,508 individuals with symptoms, referrals of 258,599 individuals to the subsequent level of examination, and approximately 55,974 individuals undergoing mammography tests. This study demonstrates that the breast cancer screening program provides a significant number of women in the target age group with breast self-examination education while raising public awareness about this disease.

Burden of noncommunicable diseases and COVID-19 pandemic prevention and control strategies

Noncommunicable diseases (NCDs) are the leading cause of death in 21st century. The risk factors for development and progression of NCDs include sedentary lifestyle, inadequate fruits and vegetables intake, tobacco use, high blood pressure, high total cholesterol levels, obesity, high salt intake, low physical activity, and air pollution. People with NCDs and comorbidities like hypertension, cardiovascular diseases, diabetes, chronic respiratory infection and cancer are more vulnerable to severe COVID-19 infection that ultimately results into mortality. To reduce the impact of NCDs on COVID-19 cases, prevention is the best measure. Primary and secondary level prevention of NCDs plays a main role to control bad outcome in COVID-19 cases. The strategies that are required to address this comorbidity includes integration and convergence of the existing communicable and NCD programs, strengthening health care systems by giving major focus on primary health care services, health and wellness centers, universal health coverage, updating guidelines, enhancing community participation, capacity building, appropriate policy making, multi-sectoral participation and coordination.

Incidence of Non-Communicable Diseases in Urban and Rural Areas of Indonesia

Introduction: NCDs were known of causing 74% of deaths worldwide, and 77% of all these deaths are in low- and middle-income countries. The prevalence of NCD in Indonesia has increased over the past five years as it has in the majority of other Low Middle-Income Countries (LMICs) in the Asia Pacific area. The objective of this study is to examine the incidence of non-communicable diseases (NCDs) in urban and rural areas. Methodology: This study used secondary data from the Indonesian Family Life Survey conducted in 2014-2015 (wave 5). A total of 16,204 households and 50,148 individuals were interviewed by the IFLS-5 in 2014-2015. The data reflects the entire country of Indonesia and was collected by stratified random sampling from province to residence level. We involved respondents between the ages of 18 and 64 as the inclusion criterion for this research. The exclusion criteria include those with unknown or incomplete data. A total of 26,437 participants were involved in this study. Result: People with CKD were nearly the same in urban and rural areas (55.91% and 44.09%); cholesterol disease (76.16% and 23.84%); CVD (63.38% and 36.62%); hypertension (62.57% and 37.43%); diabetes (74.42% and 25.58%); stroke (67.65% and 32.35%). Conclusions: Chronic kidney disease was nearly equal in both urban and rural; while cholesterol, cardiovascular, hypertension, diabetes, and stroke were higher in urban areas. This could be worthwhile to consider as part of improving NCD prevention and treatment. Keywords: non-communicable, rural, urban.

Characteristic of the quality of life in the young population with chronic disease

Introduction. The quality of life and health in the young population is the main component that determines the potential of the country. Study in this area is necessary to determine the adequacy of medical care, as well as the effectiveness of therapeutic and preventive measures. Purpose. Assessment of the quality of life in the young population of Astrakhan region suffering from chronic diseases. Materials and methods. The article presents the results of a study of the quality of life of the young population of the city of Astrakhan, suffering from chronic diseases. The study involved 18–44 year four hundred one resident of Astrakhan. Russian version of questionnaire SF-36 was used as the main method for assessing the quality of life in the study group. Results. In general, the quality of life in young residents of Astrakhan suffering from chronic diseases is average. The physical and social activity of respondents does not decrease, according to the results of the analysis of the physical and psychological components of health. There is a decrease in daily activity, depending on the physical condition in participants with pathologies of the genitourinary system, the hematopoietic system, the respiratory and the circulatory system. Analysis of life activity, daily activity, depending on the emotional background, social functioning, as well as the mental health of respondents, regardless of pathology, showed average values. Research limitations. The limiting factors in the study are the age composition of the study group, the set of factors studied, structure of the diseases, regional characteristics. The study did not involve patients with disabilities, as well as those suffering from severe diseases. Conclusion. The results of the study are applicable in practical healthcare to improve the quality of management and conduct of medical examinations, preventive medical examinations and dispensary observation of the population; training of personnel in the field of prevention of non-communicable diseases and the formation of a healthy lifestyle.

A Scoping Review of Non-Communicable Diseases among the Workforce as a Threat to Global Peace and Security in Low-Middle Income Countries.

Non-communicable diseases (NCDs) continue to pose a threat to public health. Although their impact on the workforce is widely recognized, there needs to be more understanding of how NCDs affect peace and security, particularly in low-middle-income countries. To address this, we conducted a scoping review and presented a narrative to explore how NCDs in the workforce threaten peace and security. Out of 570 papers screened, 34 articles, comprising 26 peer review and 8 grey literature, met the study criteria. Our findings reveal that while no study has drawn a direct relationship between NCDs in the workforce in LMICs and peace and security, several studies have demonstrated a relationship between NCDs and economic growth on one hand and economic growth and peace and security on the other. Therefore, using economic growth as a proximal factor, our findings show three pathways that link NCDs in the workforce to peace and security: (i) NCDs lead to low productivity and poor economic growth, which can threaten public peace and security; (ii) NCDs in the workforce can result in long-term care needs, which then puts pressure on public resources and have implications for public expenditure on peace and security; and (iii) household expenditures on caring for a family member with an NCD can destabilize families and create an unfavourable condition that threatens peace and security. This research highlights the dual threat of NCDs to health and security, as they impact human resources and community structures crucial for peace and security. The results underscore the importance of considering the workplace as a strategic setting for NCD prevention, which will have long-term implications for economic growth and peace and security.

Is per capita fish consumption in Latin America aligned with international recommendations for a healthy diet?

The World Health Organization (WHO) is urging Latin American countries to prioritize the prevention of chronic noncommunicable diseases. Diet is a crucial factor in determining one’s health, and healthy eating recommendations emphasize the consumption of fish at least twice a week due to its protein, vitamin, mineral, and essential fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This review was designed to compare the status of fish consumption as a source of EPA and DHA fatty acids in some Latin American countries (namely Brazil, Chile, Colombia, and Ecuador), and comparisons with international recommendations within a healthy diet could contribute to the WHO’s call for a focus on preventing the aforementioned diseases in the region. A comprehensive literature search was conducted from January to October 2022 using PubMed, Scopus, EBSCO, and government compendia. Keywords included “fish,” “consumption,” “fatty acids,” “nutrients,” and “Latin America;” and “fish,” “chronic non-communicable diseases,” “all-cause mortality,” “obesity,” “cancer,” “neurodegenerative diseases,” “metabolic diseases,” “diabetes,” “polycystic ovary syndrome,” and “metabolic syndrome.” In countries such as Chile, Brazil, and Colombia, per capita fish consumption falls below WHO’s recommended levels, and the most commonly eaten species do not contain sufficient polyunsaturated fatty acids to provide an optimal intake of EPA and DHA. It is therefore recommended that each country review its dietary guidelines and fish recommendations based on the most commonly consumed species to ensure that their populations obtain the recommended intake of EPA and DHA fatty acids and thus the benefits related to the prevention of chronic noncommunicable diseases.

Optimalisasi Kesadaran Kesehatan Warga Desa Sarirogo dengan Sosialisasi Hidup Sehat dan Implementasi Medical Check-up

This study aims to thoroughly explore the role of medical check-ups in maintaining the basic physical health of the residents of Sarirogo Village, with a particular focus on the prevention of non-communicable diseases, which have been on the rise in the area. The background of this research is based on the fact that there is a high prevalence of non-communicable diseases, such as hypertension, diabetes, and cardiovascular diseases, that often go undetected in their early stages. This is primarily due to a lack of public awareness about the importance of regular health checkups, as well as limited access to adequate healthcare services. As a result, delayed diagnoses exacerbate the overall health conditions within the community. This study employs a qualitative approach using a literature review method to analyze sources from relevant scientific journals. These sources serve as the theoretical foundation to understand the relationship between the frequency of medical check-ups and the prevention of chronic disease progression. The findings of this study highlight the significant role that medical check-ups play in the early detection of various potentially life-threatening health conditions, thereby preventing the development of more serious illnesses. Based on these findings, this research emphasizes the urgent need to enhance the accessibility of regular medical check-up services for the residents of Sarirogo Village, alongside the necessity to raise collective awareness about the benefits of routine health screenings.

Prevalence of Lifestyle Factors Among Primary Care Physicians: A Cross-Sectional Study in Al-Ahsa, Saudi Arabia.

Introduction The importance of a healthy lifestyle has grown in significance on a global scale, as it offers a vital means of preventing and managing a range of related illnesses. Consequently, maintaining a healthy lifestyle is of paramount importance for the prevention and management of non-communicable diseases. The lifestyle behaviors of healthcare workers exert a significant influence on their attitudes and counseling methods, as they play a pivotal role in the promotion of health and the dissemination of lifestyle education to patients and the general population. Objective The objective of this study was to examine the prevalence of lifestyle factors among primary care physicians in Al-Ahsa Governorate, including smoking, body mass index, nutrition, physical activity, and caffeine consumption. Methods The study was conducted between December 2023 and February 2024. A total of 233 primary care physicians in Al-Ahsa were selected through a probability multistage clustering sampling method. Data were collected via the distribution of a self-administered questionnaire to the primary care physicians and were analyzed using the chi-square test. Results A greater proportion of primary care physicians exhibited multiple unhealthy lifestyle factors (166/233, 71.2%). The most prevalent lifestyle factor was low physical activity (169/233, 73%), followed by poor nutrition (121/233, 52%), obesity (120/233, 51.51%), smoking (37/233, 15.88%), and caffeine consumption (22/233, 9%). The majority of primary care physicians with optimal health status are employed in primary healthcare (PHC) facilities situated in the eastern region followed by the southern region in Al-Ahsa Governorate. Conclusion The study findings revealed a prevalence of unhealthy lifestyle factors among the majority of primary care physicians in the Al-Ahsa Governorate. The most prevalent unhealthy lifestyle factor among the participants was low physical activity.

Carnosic acid, a novel food-source AT1R antagonist and its anti-hypertension mechanism

Hypertension is the most prevalent non-communicable disease, affecting billions of people worldwide. Discovery and development of natural antihypertensive lead compounds or drugs are important to resolve the limitations of existing antihypertensive drug safety and resistance. This investigation verified that carnosic acid (CA), an important active ingredient of rosemary, an edible spice plant, indicates a significant anti-hypertensive activity in spontaneous hypertension rats by targeting AT1R. Moreover, our research indicated that CA shared a comparable antagonistic mechanism with established synthetic angiotensin II receptor blockers (ARBs), as it occupies the binding sites of Angiotensin II (AngII) at His6 and Pro7 within the AT1R's ligand-binding pocket. Notably, CA exerted better anti-hypertensive activity since it could not break the Asn1113.35-Asn2957.46 hydrogen bond to stabilize the AT1R inactive state. As the first potent AT1R antagonist identified in a natural food source, CA is poised to become a novel anti-hypertensive lead compound, distinguished by its unique skeleton structure different from conventional ARBs. This research lays a valuable theoretical groundwork for the future exploration of CA and rosemary extract in both fundamental studies and clinical applications.

Establishing a Consensus-Based Framework for the Use of Wearable Activity Trackers in Health Care: Delphi Study.

Physical activity (PA) plays a crucial role in health care, providing benefits in the prevention and management of many noncommunicable diseases. Wearable activity trackers (WATs) provide an opportunity to monitor and promote PA in various health care settings. This study aimed to develop a consensus-based framework for the optimal use of WATs in health care. A 4-round Delphi survey was conducted, involving a panel (n=58) of health care professionals, health service managers, and researchers. Round 1 used open-response questions to identify overarching themes. Rounds 2 and 3 used 9-point Likert scales to refine participants' opinions and establish consensus on key factors related to WAT use in health care, including metrics, device characteristics, clinical populations and settings, and software considerations. Round 3 also explored barriers and mitigating strategies to WAT use in clinical settings. Insights from Rounds 1-3 informed a draft checklist designed to guide a systematic approach to WAT adoption in health care. In Round 4, participants evaluated the draft checklist's clarity, utility, and appropriateness. Participation rates for rounds 1 to 4 were 76% (n=44), 74% (n=43), 74% (n=43), and 66% (n=38), respectively. The study found a strong interest in using WATs across diverse clinical populations and settings. Key metrics (step count, minutes of PA, and sedentary time), device characteristics (eg, easy to charge, comfortable, waterproof, simple data access, and easy to navigate and interpret data), and software characteristics (eg, remote and wireless data access, access to multiple patients' data) were identified. Various barriers to WAT adoption were highlighted, including device-related, patient-related, clinician-related, and system-level issues. The findings culminated in a 12-item draft checklist for using WATs in health care, with all 12 items endorsed for their utility, clarity, and appropriateness in Round 4. This study underscores the potential of WATs in enhancing patient care across a broad spectrum of health care settings. While the benefits of WATs are evident, successful integration requires addressing several challenges, from technological developments to patient education and clinician training. Collaboration between WAT manufacturers, researchers, and health care professionals will be pivotal for implementing WATs in the health care sector.

Health research priorities in Pakistan: A Child Health and Nutrition Research Initiative (CHNRI) exercise.

The National Health Vision of Pakistan 2016-2025 is to provide affordable health services through a resilient and responsive health system for achieving health-related Sustainable Development Goals (SDGs) and universal health coverage (UHC) targets. Through this study, we wanted to identify the research priorities at the national level that would help to provide the necessary evidence for achieving this vision through essential package of health services (EPHS). We followed World Health Organization (WHO) guidance for undertaking research priority-setting exercises and the Child Health and Nutrition Research Initiative (CHNRI) methodology in conducting this national exercise. The proposed research options for the next three to five years were identified in five thematic research areas: communicable diseases; non-communicable diseases (NCDs) and injuries; reproductive, maternal, newborn, child, and adolescent health (RMNCAH); mental health; and health systems and services. We assessed these research options against five priority-setting criteria: feasibility, public health importance, sustainability, equity, and community involvement. Forty-three experts proposed 272 research ideas, which were consolidated into a list of 155 research options and sent back to the experts for scoring. The top 10 research priorities in each of the five research areas were identified based on the weighted research priority scores (wRPS) rankings. Tuberculosis and antimicrobial resistance; NCD screening and prevention; maternal and neonatal mortality; mental health of children, adolescents, and youth; and human resource management were the issues that were most frequently reflected in the list of research priorities. Most research priorities aimed to identify barriers to the implementation of interventions. Through this exercise, we identified the top 50 national health research priorities, which also have a strong correlation with EPHS interventions. To realise the findings of this exercise, funding agencies should establish funding mechanisms to support the undertaking of the identified research priorities, and academic researchers should actually utilise them in future studies. Such activities could hopefully contribute to achieving the national health goals.