The Effect of Empowering Health Cadres Through Whatsapp on the Knowledge and Skills of Health Cadres in Hypertension Management
DOI:
https://doi.org/10.37287/ijghr.v8i3.1397Keywords:
cadre empowerment, health education, hypertension, noncommunicable diseases, telehealthAbstract
Hypertension remains one of the leading causes of global mortality, affecting approximately 1.28 billion adults worldwide, yet only 21% successfully manage to control their blood pressure. This highlights the urgent need for community-based strategies, particularly through the empowerment of health cadres. Digital health education interventions—such as those utilizing WhatsApp—are considered promising for enhancing cadres’ competencies in hypertension management. The aim of this study was to determine the effect of empowering health cadres through Whatsapp on the knowledge and skills of cadres in hypertension management. This study employed a quasi-experimental design with a pretest-posttest control group approach. The first phase involved the development of a training module informed by a literature review, field study, and expert consultation. Data collection was done using purposive sampling with inclusion and exclusion criteria, a total of 60 respondents, 30 intervention and control groups each. In the second phase, an intervention was conducted involving 60 health cadres (30 in the intervention group and 30 in the control group) within the jurisdiction of Tateli public health care, delivered via WhatsApp. Data were analyzed using the Wilcoxon Signed Rank Test and the Mann-Whitney U Test, with a significance level set at p < 0.05. The findings revealed a statistically significant improvement in both knowledge and skills among cadres in the intervention group. Knowledge increased from moderate (90%) to good (73.3%), and skills from moderate (90%) to good (93.3%), with p < 0.001. No significant changes were observed in the control group. WhatsApp-based educational interventions are effective in improving health cadres' knowledge and skills in hypertension management. Given its accessibility, affordability, and practicality, WhatsApp serves as a strategic and sustainable tool for ongoing cadre training in the prevention and control of non-communicable diseases at the community level.
References
Abel, M. L., Lee, J., Sheth, K. D., Desai, M. S., & Buchanan, D. (2023). Strengthening the community health workforce through education and training: A systematic review. Journal of Community Health, 48(1), 12–24. https://doi.org/10.1007/s10900-022-01095-2
Abila, B., & Kantola, J. (2013). Knowledge management for sustainable competitiveness in the health sector. International Journal of Health Care Quality Assurance, 26(6), 514–530. https://doi.org/10.1108/IJHCQA-09-2011-0053
Alligood, M. R. (2017). Nursing theorists and their work (9th ed.). Elsevier Health Sciences.
American Heart Association. (2017). ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. https://doi.org/10.1161/HYP.0000000000000065
Augustovski, F., García Martí, S., Pichon-Riviere, A., Rubinstein, A., & Glujovsky, D. (2018). Empowering health agents in low-resource settings: Evidence from community-based hypertension programs. Global Heart, 13(4), 361–368. https://doi.org/10.1016/j.gheart.2018.09.004
Chan, C. V., Matthews, L. A., & Kaufman, D. R. (2019). Facilitators and barriers to patient engagement in mHealth interventions: Systematic review. Journal of the American Medical Informatics Association, 26(10), 1069–1079. https://doi.org/10.1093/jamia/ocz084
Dwinger, S., Kriston, L., Härter, M., & Dirmaier, J. (2020). Communication training and its influence on patient education and knowledge: A systematic review. Patient Education and Counseling, 103(4), 697–706. https://doi.org/10.1016/j.pec.2019.10.002
Elizar, A., & Tanjung, M. (2018). Kompetensi kader dalam pelayanan kesehatan ibu dan anak di wilayah kerja Puskesmas. Jurnal Kesehatan Masyarakat Andalas, 13(2), 97–105. https://doi.org/10.24893/jkma.v13i2.446
Firmansyah, F., Putri, E. R., & Wulandari, R. (2020). Efektivitas pelatihan kader dalam pengendalian hipertensi. Jurnal Pengabdian Kepada Masyarakat, 6(1), 13–20.
Gamage, D. G., Rathnayake, S., & Senarathna, L. (2020). Effectiveness of community health volunteers on management of hypertension: A literature review. Journal of Community Health, 45(3), 635–644. https://doi.org/10.1007/s10900-019-00744-6
He, J., Irazola, V., Mills, K. T., Poggio, R., Beratarrechea, A., Dolan, J., ... & Tavel, H. M. (2017). Effect of a community health worker–led multicomponent intervention on blood pressure control in low-income patients in Argentina: A randomized clinical trial. JAMA, 318(11), 1016–1025. https://doi.org/10.1001/jama.2017.11358
Ingenhoff, A., Kohring, M., Weder, F., & Arlt, D. (2022). Mobile health interventions in primary care: Challenges in rural areas. BMC Primary Care, 23(1), 42. https://doi.org/10.1186/s12875-022-01590-0
Ivic, R., Zekic, N., & Radojevic, T. (2022). Community health workers and their role in chronic disease prevention. Public Health Frontiers, 10, 987421. https://doi.org/10.3389/fpubh.2022.987421
Kementerian Kesehatan Republik Indonesia. (2018). Petunjuk teknis pembinaan posbindu penyakit tidak menular (PTM). Direktorat Jenderal Pencegahan dan Pengendalian Penyakit.
Kementerian Kesehatan Republik Indonesia. (2020). Profil kesehatan Indonesia tahun 2020. Kemenkes RI.
Li, R., Liang, N., Bu, F., & Hesketh, T. (2019). The effectiveness of self-management of hypertension in adults using mobile health: Systematic review and meta-analysis. JMIR mHealth and uHealth, 7(3), e10241. https://doi.org/10.2196/10241
Mbuthia, F., Ochieng, B., & Wanyonyi, D. (2022). Health system challenges in hypertension control in Sub-Saharan Africa: A systematic review. International Journal of Hypertension, 2022, 1–9. https://doi.org/10.1155/2022/7460934
Nguyen-Huynh, M. N., Skolarus, L. E., Luong, T. N., & Reeves, M. J. (2022). Training community health workers to improve cardiovascular health outcomes: A review of evidence and practice. Preventive Medicine Reports, 26, 101759. https://doi.org/10.1016/j.pmedr.2022.101759
Okvireslian, D. (2021). Peran WhatsApp dalam komunikasi edukatif komunitas kesehatan. Jurnal Komunikasi Kesehatan, 12(2), 87–96.
Powers, B. J., Olsen, M. K., Oddone, E. Z., & Bosworth, H. B. (2019). Enhancing community health worker performance: The importance of a motivational framework. BMC Public Health, 19, 102. https://doi.org/10.1186/s12889-018-6299-3
Puskesmas Tateli. (2023). Laporan kegiatan dan data posbindu PTM tahun 2023. Kabupaten Minahasa.
Raffa, J. D., Beck, C. A., & Reinschmidt, K. M. (2020). Competency-based training for health volunteers: Linking knowledge to performance. Health Education & Behavior, 47(4), 590–600. https://doi.org/10.1177/1090198120919150
Riskesdas. (2018). Laporan nasional riskesdas 2018. Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan RI.
Sjölin, J. K., Almqvist, R., & Persson, L. O. (2020). Building competence in community-based health programs: A qualitative study of training and supervision of health workers. BMC Health Services Research, 20, 723. https://doi.org/10.1186/s12913-020-05584-1
Sopiah, S., & Sangaji, R. (2018). Pengetahuan dan implementasi manajemen kesehatan masyarakat. Jurnal Ilmu Kesehatan Masyarakat, 9(2), 112–119.
Susianta, A. (2021). Keterampilan sebagai kunci keberhasilan dalam pelayanan kesehatan masyarakat. Jurnal Kesehatan Komunitas, 7(3), 143–150.
Tang, J. W. T., Wong, R. C. W., & Liu, Y. M. (2018). Mobile health-supported education programs to improve self-care among patients with hypertension: A randomized controlled trial. BMC Cardiovascular Disorders, 18, 134. https://doi.org/10.1186/s12872-018-0870-4
Todorova, E. K., Costa, D. D., & Guzzardo, M. T. (2021). Sustaining motivation and retention among community health volunteers: Insights from a realist evaluation. Global Health Action, 14(1), 1893393. https://doi.org/10.1080/16549716.2021.1893393
Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., ... & Schlaich, M. P. (2020). 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension, 75(6), 1334–1357. https://doi.org/10.1161/HYPERTENSIONAHA.120.15026
Vedanthan, R., Fuster, V., & Kimaiyo, S. (2019). Community health workers and noncommunicable disease prevention: A cross-sectional study in rural Kenya. Global Heart, 14(2), 103–110. https://doi.org/10.1016/j.gheart.2019.01.002
World Health Organization. (2023). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension
Yang, S., Kong, T., & Zhang, M. (2014). The influence of knowledge on health behavior in hypertension patients. Patient Preference and Adherence, 8, 251–257. https://doi.org/10.2147/PPA.S57321
Yuliatri, R. M., Suryani, R., & Santoso, B. (2022). Peran kader kesehatan dalam pengendalian penyakit tidak menular di masyarakat. Jurnal Promkes, 10(1), 13–22.
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