HEALTH PROMOTION BEHAVIOUR FOR NON-COMMUNICABLE DISEASES AMONG HEALTHCARE WORKERS IN KAKAMEGA COUNTY, KENYA

Micky Oloo Olutende, Maximilla N. Wanzala, Elizabeth Mse, Edwin Kadima Wamukoya

Abstract


Introduction: The rising burden of non-communicable diseases poses a great health system challenge in Kenya. Healthcare workers have a critical role to play in health promotion, in addressing patients’ lifestyle risk factors. However, their own lifestyle habits can influence their attitude and practices towards patient care. Opportunistic counselling of patients by health professionals signifies one of the most cost-effective medical interventions in combatting non-communicable diseases. Objective: To determine the attitudes and practice of health promotion for the prevention and management of non-communicable diseases among healthcare workers In Kakamega county. Methods: A cross-sectional mixed method study was carried out from June to July 2018 at Kakamega county referral hospital. For the quantitative method, one hundred and eighty-five doctors and nurses were recruited through stratified sampling. Data on healthcare workers; socio-demographic characteristics, lifestyle practice, attitude, and practice of health promotion was collected through self- administered questionnaires. Frequency and percentage distributions tables were used to initially describe the study population while, Chi- square test of significance was used to evaluate the association between healthcare workers attitudes and practice of health promotion and their socio-demographic features. Secondly, a total of 12 doctors and nurses were purposively selected based on age, gender and profession of participants for the qualitative method. Data on healthcare workers perspective on health promotion and organizational support factors were collected through in-depth interviews. The recorded interviews were transcribed and data analysis was done using content analysis of thematic areas. A verbatim approach was used to describe study findings. Results: 69.2% of the respondents were females, mean age was 36 years and the median years in profession was 12 years. The respondents exhibited good lifestyle practices with alcohol and tobacco prevalence at 30.8 %and 3.8% respectively. 72% of the respondents demonstrated a positive attitude towards health promotion while, 31% showed good health promotion practices. Less than half of the respondents inquired about a patient’s lifestyle practices during routine visit. The study found that healthcare workers with a positive attitude were four times more likely to have good health promotion practices (OR = 3.54, p<0.001). Lastly findings from the in-depth interviews revealed that staff had no written guidelines on health promotion and that the hospital management had abolished the health promotion unit. Conclusion: The results indicated that a positive health professional attitude is a precursor to good health promotive practices. Recommendation: Efforts to build capacity and support for health promotion in health services should be encouraged. Additionally, health Promotion programs for non- communicable disease should not only target the health of general population but also the health of health care workers.

Article visualizations:

Hit counter


Keywords


practices, attitudes, Kakamega county, Kenya, risk factors, prevalence, non-communicable diseases, diabetes

Full Text:

PDF

References


Abdullah, A. S., Rahman, S. M., Suen, C. W., Wing, L. S., Ling, L. W., Mei, L. Y., … Kwan, Y. H. (2006). Investigation of Hong Kong doctors’ current knowledge, beliefs, attitudes, confidence and practices: implications for the treatment of tobacco dependency. Journal of the Chinese Medical Association, 69(10), 461–471. http://doi.org/10.1016/S1726-4901(09)70310-7.

Aikins, A., Unwin, N., Agyemang, C., Allotey, P., Campbell, C., & Arhinful, D. (2010). Tackling Africa’s chronic disease burden: From the local to the global. BMC Globalization and Health, 6, 1–7.

Ampt, A. J., Amoroso, C., Harris, M. F., McKenzie, S. H., Rose, V. K., & Taggart, J. R. (2009). Attitudes, norms and controls influencing lifestyle risk factor management in general practice. BMC Family Practice, 10(1), 59. http://doi.org/10.1186/1471-2296-10-59.

Anderko, L., Roffenbender, J. S., Goetzel, R. Z., Howard, J., Millard, F., Wildenhaus, K., … Novelli, W. (2012). Promoting prevention through the affordable care act: workplace wellness. Preventing Chronic Disease, 9(9), E175. http://doi.org/10.5888/pcd9.120092.

Bakhshi, S., & While, A. E. (2014). Health professionals’ alcohol-related professional practices and the relationship between their personal alcohol attitudes and behavior and professional practices: a systematic review. International Journal of Environmental Research and Public Health, 11(1), 218–48. http://doi.org/10.3390/ijerph110100218.

Bazargan, M., Makar, M., Bazargan-Hejazi, S., Ani, C., & Wolf, K. E. (2009). Preventive, lifestyle, and personal health behaviors among physicians. Academic Psychiatry, 33(4), 289–295. http://doi.org/10.1176/appi.ap.33.4.289.

Bleich, S. N., Bennett, W. L., Gudzune, K. A., & Cooper, L. A. (2009). Impact of Physician BMI on Obesity Care and Beliefs. Obesity, 20(5), 999–1005. http://doi.org/10.1038/oby.2011.402.

Bleich, S. N., Bennett, W. L., Gudzune, K. A., & Cooper, L. A. (2012). Impact of physician BMI on obesity care and beliefs. Obesity (Silver Spring, Md.), 20(5), 999–1005. http://doi.org/10.1038/oby.2011.402.

Blumenthal-Barby, J. S., & Burroughs, H. (2012). Seeking Better Health Care Outcomes: The Ethics of Using the “Nudge.” The American Journal of Bioethics, 12(2), 1–10. http://doi.org/10.1080/15265161.2011.634481

Brotons, C., Bjorkelund, C., Bulc, M., Ciurana, R., Godycki-cwirko, M., Jurgova, E., … Vuchak, J. (2005). Prevention and health promotion in clinical practice : the views of general practitioners in Europe. Journal of Preventive Medicine, 40, 595–601. http://doi.org/10.1016/j.ypmed.2004.07.020.

Center for disease prevention. (2009). The Power of Prevention Chronic Disease... the public health challenge of the 21st century.

Chiou, S., Chiang, J., Huang, N., & Chien, L. (2014). Health behaviors and participation in health promotion activities among hospital staff: which occupational group performs better ? BMC Health Services Research, 14, 1–7.

Coe, G., & Beyer, D. (2014). The imperative for health promotion in universal health coverage. Global Health: Science and Practice, 2(1), 10–22. Retrieved from http://www.ghspjournal.org/content/2/1/10.full.pdf+html.

Dobe, M. (2012). Health Promotion for Prevention and Control of Non- communicable Diseases: Unfinished Agenda the Concept of Risk. Indian Journal of Public Health, 56(3), 180–186. http://doi.org/10.4103/0019-557X.104199.

Dresner, Y., Frank, E., Baevsky, T., Rotman, E., & Vinker, S. (2010). Screening practices of Israeli doctors’ and their patients. Preventive Medicine, 50(5–6), 300–303. http://doi.org/10.1016/j.ypmed.2010.02.005

Frank, E., Dresner, Y., Shani, M., & Vinker, S. (2013). Preventive Health Practices. Canadian Medical Association Journal, 185(8), 649–654. http://doi.org/10.1503/cmaj.121028/-/DC1

Frank, E., & Segura, C. (2009). Health practices of Canadian physicians. Canadian Family Physician Médecin de Famille Canadien, 55(8), 810–811.e7. Retrieved from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2726100&tool=pmcentrez&rendertype=abstract

Gichuki, J. W. (2014). Health care providers knowledge, attitude and practice of smoking cessation interventions in public health facilities in Kiambu county, Kenya. Unpublished Thesis, University of Nairobi.

Guo, X. H., Tian, X. Y., Pan, Y. S., Yang, X. H., Wu, S. Y., Wang, W., & Lin, V. (2007). Managerial attitudes on the development of health promoting hospitals in Beijing. Health Promotion International, 22(3), 182–190. http://doi.org/10.1093/heapro/dam010.

Gustafsson-wright, E., Duynhouwer, A., Gaag, J. Van Der, & Schultsz, C. (2012). Households in Tanzania and Insurance Fund Operational. Retrieved from http://www.aiid.org/uploads/File/publications/19_USAID_2nd_Study_Chronic Disease Final 20121025.pdf.

Hall, V., Thomsen, R. W., Henriksen, O., & Lohse, N. (2011). Diabetes in Sub Saharan Africa 1999-2011: epidemiology and public health implications. A systematic review. BMC Public Health, 11, 564. http://doi.org/10.1186/1471-2458-11-564.

Harris, M. (2008). The role of primary health care in preventing the onset of chronic disease, with a particular focus on the lifestyle risk factors of obesity, tobacco and alcohol. Commissioned Paper for National Preventative Health Taskforce, pp. 1–21. Retrieved from http://www.health.gov.au/internet/preventativehealth/publishing.nsf/Content/0FBE203C1C547A82CA257529000231BF/$File/commpaper-primary-hlth-care-harris.pdf.

Holmberg, C., Sarganas, G., Mittring, N., Braun, V., Dini, L., Heintze, C., … Müller- Nordhorn, J. (2014). Primary prevention in general practice - views of German general practitioners: a mixed-methods study. BMC Family Practice, 15(1), 103. http://doi.org/10.1186/1471-2296-15-103.

Iwuala, S., Ayankogbe, O., Olatona, F., Olamoyegun, M., Sabir, A., & Fasanmade, O. (2015). Obesity among health service providers in Nigeria: Danger to long term health worker retention. PanAfrican Medical Journal, 8688, 1–8. http://doi.org/10.11604/pamj.2015.22.1.5586.

Johansson, H., Stenlund, H., Lundström, L., & Weinehall, L. (2010). Reorientation to more health promotion in health services - a study of barriers and possibilities from the perspective of health professionals. Journal of Multidisciplinary Healthcare, 3, 213–24. http://doi.org/10.2147/JMDH.S14900.

Johansson, H., Weinehall, L., & Emmelin, M. (2009). “It depends on what you mean”: a qualitative study of Swedish health professionals â€TM views on health and health promotion. BMC Health Services Research, 12(9), 1–12. http://doi.org/10.1186/1472-6963-9-191.

Johnson, A., & Baum, F. (2001). Health promoting hospitals: A typology of different organizational approaches to health promotion. Health Promotion International, 16(3), 281–287. http://doi.org/10.1093/heapro/16.3.281.

Jonsdottir, I. H., Börjesson, M., & Ahlborg, G. (2011). Healthcare workers’ participation in a healthy-lifestyle-promotion project in western Sweden. BMC Public Health, 11(1), 448. http://doi.org/10.1186/1471-2458-11-448.

Kaduka, L. U., Kombe, Y., Kenya, E., Kuria, E., Bore, J. K., Bukania, Z. N., & Mwangi, M. (2012). Prevalence of metabolic syndrome among an urban population in Kenya. Diabetes Care, 35(4), 887–93. http://doi.org/10.2337/dc11-0537.

Kemppainen, V., Tossavainen, K., & Turunen, H. (2013). Nurses’ roles in health promotion practice: An integrative review. Health Promotion International, 28(4), 490–501. http://doi.org/10.1093/heapro/das034.

Kenyatta National Hospital. (2015). Kakamega county referral hospital, Quality Health Care. Retrieved March 24, 2015, from http://knh.or.ke/.

Khowaja, A., Mistry, R., Agha, A., & Karmaliani, R. (2010). Potential benefits and perceived need for health promoting hospitals in Pakistan: A healthcare Stakeholder’s perspective. Journal of the Pakistan Medical Association, 60(4), 274–279.

Kingma, M. (2013). Can financial incentive influence medical practice? Human Resources Development Journal, 2(1), 1–12.

Kirigia, J. M., Sambo, H. B., Sambo, L. G., & Barry, S. P. (2009). Economic burden of diabetes mellitus in the WHO African region. BMC International Health and Human Rights, 9, 6. http://doi.org/10.1186/1472-698X-9-6.

Klein, D., Guenther, C., & Ross, S. (2016). Do as I say, not as I do Lifestyles and counseling practices of physician faculty at the University of Alberta. Canadian Family Physician, 62, 393–399.

Kluger, J. (2014). Women make better Doctors than Men. TIME Magazine. Retrieved from http://healthland.time.com/2013/10/17/women-make-better-doctors-than-men/.

Kreuter, M., Shobhina, C., & Bull, F. (2009). How Does Physician Advice Influence Patient Behavior? Archives of Family Medicine, 9(May), 426–33.

Kumar, S., & Preetha, G. (2012). Health promotion: an effective tool for global health. Indian Journal of Community Medicine, 37(1), 5–12. http://doi.org/10.4103/0970-0218.94009.

Lambe, B., & Collins, C. (2010). A qualitative study of lifestyle counselling in general practice in Ireland. Family Practice, 27, 219–223. http://doi.org/10.1093/fampra/cmp086.

Law, M. R., Morris, J. K., & Wald, N. J. (2009). Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomized trials in the context of expectations from prospective epidemiological studies. BMJ (Clinical Research Ed.), 338(may19_1), b1665. http://doi.org/10.1136/bmj.b1665.

Laws, R. a, Kemp, L. a, Harris, M. F., Davies, G. P., Williams, A. M., & Eames-Brown, R. (2009). An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study. Implementation Science: IS, 4, 66. http://doi.org/10.1186/1748-5908-4-66.

Laws, R. a, Kirby, S. E., Davies, G. P. P., Williams, A. M., Jayasinghe, U. W., Amoroso, C. L., & Harris, M. F. (2008). “Should I and can I?” A mixed methods study of clinician beliefs and attitudes in the management of lifestyle risk factors in primary health care. BMC Health Services Research, 8, 44. http://doi.org/10.1186/1472-6963-8-44.

Lobelo, F., & Quevedo, I. G. De. (2014). The Evidence in Support of Physicians and Health care Providers as Physical Activity Role Models. American Journal of Lifestyle Medicine, 1.55982761. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511730/.

McHugh, C., Robinson, A., & Chesters, J. (2010). Health promoting health services: A review of the evidence. Health Promotion International, 25(2), 230–237. http://doi.org/10.1093/heapro/daq010.

Miller, S. K., Alpert, P. T., & Cross, C. L. (2008). Overweight and obesity in nurses, advanced practice nurses, and nurse educators. Journal of the American Academy of Nurse Practitioners, 20(5), 259–65. http://doi.org/10.1111/j.1745-7599.2008.00319.x.

Ministry of Health. (2014a). Global Adult Tobacco Survey - 2014 Executive Summary. Ministry of Health. Retrieved from http://www.health.go.ke/images/gats/GATS 2014_Kenya_Executive_Summary.pdf.

Ministry of Health. (2014b). Kenya health sector strategic and investment plan (KHSSP) 2014-2018.

Ministry of Health. (2014c). National strategy for the prevention and control of noncommunicable disease 2015-2030. Retrieved from http://www.paho.org.

Ministry of Health. (2015a). Kenya National Health Accounts 2012/13. Retrieved from http://www.healthpolicyproject.com/pubs/523_KenyaNHA.pdf.

Ministry of Health. (2015b). Kenya STEPwise Survey for Non-communicable Diseases Risk Factors 2015 Report.

Ministry of Public Health and Sanitation. (2010). Kenya National Diabetes Strategy 2010-2015. Ministry of Public Health and Sanitation. Retrieved from http://diabetes-communication.org/wordpress/wp-content/uploads/2012/09/Kenya-National-Diabetes-Strategy-2010-2015-Complete.pdf.

Montali, F., Campaniello, G., Fontechiari, S., Ferrari, M., & Vitali, P. (2016). Alcohol consumption and physical activity among healthcare workers. Clinical Health Promotion, 6(6), 21–26.

Nugent, R. (2008). Chronic diseases: a growing problem in developing countries. Diabetesvoice, 53(May), 17–20.

Oberg, E. B., & Frank, E. (2009). Physicians’ health practices strongly influence patient health practices. The Journal of the Royal College of Physicians of Edinburgh, 39(4), 290–291. http://doi.org/10.4997/JRCPE.2009.422.Physicians.

Omar, O. A. (2007). lifestyle-related risk factors for non-communicable diseases among professionals in Nairobi. MPH Thesis Unpublished, University of Nairobi.

Parry, C. D., Patra, J., & Rehm, J. (2011). Alcohol consumption and non-communicable diseases: epidemiology and policy implications. Addiction (Abingdon, England), 106(10), 1718–24. http://doi.org/10.1111/j.1360-0443.2011.03605.x.

Paz, H., & Luquis, R. (2014). Attitudes About and Practices of Health Promotion and Prevention Among Primary Care Providers. Health Promotion Practice, 16(5), 745–755. http://doi.org/10.1177/1524839914561516.

Pender, N. J. (2011). Heath Promotion Model Manual. Retrieved from http://deepblue.lib.umich.edu/handle/2027.42/85350.

Poulsen, K., Cleal, B., Clausen, T., & Andersen, L. L. (2014). Work, diabetes and obesity: a seven-year follow-up study among Danish health care workers. PloS One, 9(7), e103425. http://doi.org/10.1371/journal.pone.0103425.

Republic of Kenya. (2012). Performance Audit Report of the Auditor- General Specialized Healthcare Delivery at Kenyatta National Hospital.

Robinson, H. M., & Hort, K. (2012). Non-communicable diseases and health systems reform in low-and-middle-income countries. Pacific Health Dialog, 18(13), 179–90. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23240355.

Saeys, F., & Cammu, H. (2014). GPs’ attitudes on a healthy lifestyle: A survey of GPs in Flanders. British Journal of General Practice, 64(627), e664–e669. http://doi.org/10.3399/bjgp14X681853.

Saliba, M., Sammut, M. R., Vickers, K. S., & Calleja, N. (2011). Health behaviour counselling in primary care: general practitioner - reported rate and confidence. Malta Medical Journal, 23(1), 22–28.

Sargeant, J. (2012). Qualitative Research Part II: Participants, Analysis, and Quality Assurance. Journal of Graduate Medical Education, (March), 1–3.

Sebo, P., Bouvier Gallacchi, M., Goehring, C., Künzi, B., & Bovier, P. (2007). Use of tobacco and alcohol by Swiss primary care physicians: a cross-sectional survey. BMC Public Health, 7, 5. http://doi.org/10.1186/1471-2458-7-5.

Shai, I., Erlich, D., Cohen, A. D., Urbach, M., Yosef, N., Levy, O., & Shahar, D. R. (2012). The effect of personal lifestyle intervention among health care providers on their patients and clinics; the Promoting Health by Self Experience (PHASE) randomized controlled intervention trial. Journal of Preventive Medicine, 55(4), 285–291. http://doi.org/10.1016/j.ypmed.2012.08.001.

Sharma, S., Anand, T., Kishore, J., Dey, B. K., & Ingle, G. K. (2014). Prevalence of Modifiable and Non-Modifiable Risk Factors and Lifestyle Disorders among Health Care Professionals. Astrocyte, 1(3), 178–85. http://doi.org/10.4103/2349-0977.157757.

Skaal, L., & Pengpid, S. (2011). Obesity and health problems among South African healthcare workers: do healthcare workers take care of themselves? South African Family Practice, 53(6), 563–567. http://doi.org/10.1080/20786204.2011.10874153.

Spanou, C., Simpson, S. a, Hood, K., Edwards, A., Cohen, D., Rollnick, S., … Butler, C. C. (2010). Preventing disease through opportunistic, rapid engagement by primary care teams using behaviour change counselling (PRE-EMPT): protocol for a general practice- based cluster randomised trial. BMC Family Practice, 11, 69. http://doi.org/10.1186/1471-2296-11-69.

Stead, M., Angus, K., Holme, I., Cohen, D., Tait, G., Peña, C. C., … Costa, J. (2009). Factors influencing European GPs’ engagement in smoking cessation: A multi-country literature review. British Journal of General Practice, 59(566), 682–690. http://doi.org/10.3399/bjgp09X454007

Thaker, R., Perrin, K., Daley, E., Vamos, C., & Patel, P. (2015). Knowledge, Attitude and Health Seeking Behavior of Health Care Professionals regarding Breast and Cervical Cancer at Indian Medical College. NHL Journal of Medical Sciences, 4(1), 31–39.

Tyzuk, K. (2012). Physician health: A review of lifestyle behaviors and preventive health care among physicians. British Columbia Medical Journal, 54(8), 419–423.

Ulla, W., Uwe, F., Anke, N., Fischer, C., Hussein, R. J., & Schwartz, F. W. (2010). Putting prevention into practice: qualitative study of factors that inhibit and promote preventive care by general practitioners, with a focus on elderly patients. BMC Family Practice, 11, 68. http://doi.org/10.1186/1471-2296-11-68.

US Department of Health and Human Services. (2008). Clinical Interventions for Tobacco Use and Dependence. US Department of Health and Human Services. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK63948/.

Vickers, K. S., Kircher, K. J., Smith, M. D., Petersen, L. R., & Rasmussen, N. H. (2007). Health behavior counseling in primary care: Provider-reported rate and confidence. Family Medicine, 39(10), 730–735.

WHO. (1986). Ottawa Charter for Health Promotion. Copenhagen, Denmark.

WHO. (2005). Preventing Chronic Diseases: A Vital Investment. World Health. Retrieved from http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Preventing+Chronic+Diseases:+A+Vital+Investment#3.

WHO. (2010). Global Status Report on Noncommunicable diseases 2010. Retrieved from http://whqlibdoc.who.int/publications/2011/9789240686458_eng.pdf?ua=1.

WHO. (2013a). Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Retrieved from http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf

WHO. (2013b). Global Strategy on Diet, Physical Activity and Health. Retrieved from http://www.who.int/dietphysicalactivity/media/en/gsfs_fv.pdf

WHO. (2014a). Global Status Report on Noncommunicable Diseases 2014.

WHO. (2014b). Noncommunicable diseases country profiles 2014-Kenya. Retrieved from http://www.who.int/nmh/countries/ken_en.pdf?ua=1.

WHO. (2015). Physical Activity and Adults. Retrieved from http://www.who.int/dietphysicalactivity/factsheet_adults/en/.

WHO-EURO. (2005). Health promotion in hospitals: Evidence and quality management. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0008/99827/E86220.pdf.




DOI: http://dx.doi.org/10.46827/ejpe.v6i12.3687

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021 Micky Oloo Olutende, Maximilla N. Wanzala, Elizabeth Mse, Edwin Kadima Wamukoya

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2015 - 2023. European Journal of Physical Education and Sport Science (ISSN 2501 - 1235) is a registered trademark of Open Access Publishing Group. All rights reserved.

This journal is a serial publication uniquely identified by an International Standard Serial Number (ISSN) serial number certificate issued by Romanian National Library (Biblioteca Nationala a Romaniei). All the research works are uniquely identified by a CrossRef DOI digital object identifier supplied by indexing and repository platforms. All authors who send their manuscripts to this journal and whose articles are published on this journal retain full copyright of their articles. All the research works published on this journal are meeting the Open Access Publishing requirements and can be freely accessed, shared, modified, distributed and used in educational, commercial and non-commercial purposes under a Creative Commons Attribution 4.0 International License (CC BY 4.0).