BACK GROUND: Although being a low-middle income country, Vietnam has been experiencing an epidemiologic transition to that of a developing country with an increasing prevalence of non-communicable diseases. The key risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam, particularly hypertension (HTN). In as much, the burden of CVD will continue to increase in Vietnamese men and women unless effective prevention and control measures are put in place.
STUDY OBJECTIVES AND DESIGN: The objectives of the proposed project are to develop a multi-faceted community-based intervention, based on a Storytelling method which has been shown to be effective in other minority populations, for the control of elevated blood pressure (BP) in adults in Vietnam. We are proposing a pilot cluster-randomized trial to test the feasibility of a large scale effectiveness trial. Four communities (with a total of 100 hypertensive patients) will be randomized into either an intervention (n=2) or comparison group (n=2) (matching on population size); persons with HTN will be randomly assigned to intervention or control status based on their community of residence. Eligible and consenting participants in the intervention group will receive culturally and literacy appropriate HTN related educational materials and in-person sessions through viewing DVDs of stories from patients with HTN (Storytelling) given by trained health workers. The DVDs will include stories about the health consequences of uncontrolled HTN, overcoming barriers to HTN control, and adherence to prescribed medication and lifestyle changes. Primary health care providers in the intervention communities will also be empowered through intensive training and education on HTN control. In communities assigned to usual care, persons will view comparison DVDs, which only contain guidelines on HTN, and will be in a non-interactive format without storytelling or supplementary materials, and receive common non-communicable diseases related education as currently provided at local community health centers. This project addresses a serious clinical and public health problem in Vietnam by implementing the first community-based study using a culturally-literacy appropriate HTN intervention for this population.
PUBLIC HEALTH RELEVANCE: The proposed community-based research project will develop a novel educational intervention for the control of hypertension in Vietnam. A feasibility trial will be conducted. This is a major clinical and public health problem in this developing country.
The Phase 1 of the project completed. Two DVDs that contain the stories of 10 patients who have controlled their blood pressure successfully were produced. The Phase 2 project is ongoing.
The objective of Phase 2 is to conduct a pilot cluster Randomized Controlled Trial (RCT) with the target enrolment of 100 hypertensive patients, who reside in 4 communes including Xuan Quan (Van Giang district), Viet Hung (Van Lam district), Tan Viet (Yen My district) and Bach Sam (My Hao district). Four communes were randomized into either intervention (50 patients), or control group (50 patients).
On July 23, 2015, a training workshop was organized at the My Hao district. Health officers, doctors, and health care staff from the Hung Yen Health Department, district hospitals, and commune heath centers were invited to participate in this meeting. The objectives of this meeting were to introduce Phase 2 of the project and to provide details on its activities including screening, recruitment, and data collection activities.
In late July and early August 2015, the screening was conducted. As a result, 100 hypertensive patients, who satisfied the study eligibility criteria, were enrolled into the study.
At the time of baseline enrollment, patients were interviewed and had their blood pressure according to the standardized study protocol. Patients received a DVD player and the first of an eventual 2 DVD’s including 5 stories to view at home. They will receive the second DVD containing the other 5 stories at the 3-month follow up visit. They were carefully instructed carefully on how to view the DVD and will continue to receive technical support throughout the study period. Patients will return for follow up visits at 1, 3, 6, and 12 months after enrolment.