Non-communicable diseases (e.g., hypertension, type 2 diabetes mellitus, chronic respiratory diseases [asthma and chronic obstructive pulmonary disease]) in flood-prone, low-resource settings Other
Conditions
Interventions
The intervention will leverage existing health system structures to deliver integrated NCD care during flood events, led by primary care teams and Accredited Social Health Activists (ASHAs). The focus
Sponsors
University of Birmingham
Eligibility
Sex/Gender
All
Age
18 Years to 120 Years
Inclusion criteria
Inclusion criteria: 1. Adults aged 18 years and above 2. Residing in the flood-prone study cluster since May of the same year (covering the recent flood period and 2 months prior for pre-flood preparations) 3. Have a self-reported diagnosis of one or more study conditions hypertension, diabetes, or chronic respiratory diseases (asthma and COPD) diagnosed before the previous May and currently receiving medication
Exclusion criteria
Exclusion criteria: 1. Patient unable to converse in Hindi or English or not cognitively coherent so that they cannot consent 2. Likely to move away from the current house in the next 18 months (until May 2027)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Medication adherence measured using the Adherence to Refills and Medications Scale (ARMS-12), a validated 12-item questionnaire. Responses are dichotomised based on a threshold score of 12. Timepoints: S1 (baseline), S3 (post-intervention) 2. Flood-proof kit status measured through direct observation and participant self-report regarding the presence of the kit, possession of the NCD handover card, and documentation of prescribed medications. Timepoints: S1 (baseline), S3 (post-intervention | — |
Secondary
| Measure | Time frame |
|---|---|
| Patient-related: 1. Inpatient admission (any cause and NCD-related), measured by self-report using a patient questionnaire at S1 (baseline), 6 months post baseline (S2), S3 (post-intervention), 6 months post-endline (S4) 2. Outpatient consultation for NCD exacerbations: Self-report of flare-ups or inpatient admissions using a questionnaire at S1, S2, S3, S4 3. Mental health (depression) measured using Patient Health Questionnaire-8 (PHQ-8); anxiety using Generalized Anxiety Disorder (GAD) at S1, S3 4. Blood pressure measured using the WHO STEP protocol (average of 2nd and 3rd readings) at S1, S2, S3, S4 5. Respiratory symptoms (chronic respiratory distress patients) measured using the modified Medical Research Council (mMRC) scale and the Chronic Airways Assessment Test (CAAT) at S1, S2, S3, S4 Healthcare related: 1. Training coverage (HF/ASHA workers) measured via training registers during training 2. Post-training knowledge measured using written MCQ tests (pre- and post-training) during training 3. Availability of HF flood-proof kit and NCD drugs measured using observation checklist pre-flood (July–September) Patient-reported implementation: 1. Carrying a flood-proof kit to camp measured using patient questionnaire at S1, S3 2. Carrying handover card to camp measured using patient questionnaire at S1, S3 3. Knowledge/use of camp NCD services self-reported via questionnaire at S1, S3 4. Mental health intervention use self-reported at S1, S2, S3, S4 5. Medication availability during flood measured using patient questionnaire (binary or categorical scale) at S1, S3 6. Receiving preparedness advice self-reported at S1, S3 | — |
Countries
India
Contacts
Public ContactSemira Manaseki-Holland
Outcome results
None listed