Towards the Development of an Intervention to Address Social Determinants of Non-Communicable Disease in Kerala, India: A Mixed Methods Study

Martin Webber, Jacques Joubert, Meredith Fendt-Newlin, Saju Madavanakadu Devassy, Lorane Scaria, Anuja Maria Benny and Lynette Joubert
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Martin Webber: International Centre for Mental Health Social Research, Department of Social Policy and Social Work, University of York, York YO10 5DD, UK
Jacques Joubert: Department of Neurology, St Vincent’s Hospital Melbourne, VIC 3065, Australia
Meredith Fendt-Newlin: International Centre for Mental Health Social Research, Department of Social Policy and Social Work, University of York, York YO10 5DD, UK
Saju Madavanakadu Devassy: Department of Social Work, Rajagiri College of Social Sciences, Cochin, Kerala 683 104, India
Lorane Scaria: Department of Social Work, Rajagiri College of Social Sciences, Cochin, Kerala 683 104, India
Anuja Maria Benny: Department of Social Work, Rajagiri College of Social Sciences, Cochin, Kerala 683 104, India
Lynette Joubert: Department of Social Work, Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia

IJERPH, 2020, vol. 17, issue 22, 1-19

Abstract: In India, cardiovascular disease (CVD), with hypertension as its foremost risk factor, has the highest prevalence rate of non-communicable diseases (NCDs) and a rising mortality. Previous research has found a clustering of behavioural and social risks pertaining to NCDs, though the latter are infrequently addressed in public health interventions in India. This paper reaches toward the development of a social intervention to address social determinants of NCD relating to hypertension and diabetes. We used Theory of Change (ToC) as a theoretical approach to programme design. Mixed methods were used, including qualitative interviews with community members ( n = 20), Accredited Social Health Activists ( n = 6) and health professionals ( n = 8), and a stakeholder workshop ( n = 5 participants). The recruitment of participants from one local area in Kerala enabled us to map service provision and gain a holistic understanding of how to utilise the existing workforce to target social risk factors. The findings suggest that social interventions need to focus on ensuring health behaviour information reaches all parts of the community, and that those with more social risk factors are identified and supported to engage with treatment. Further research is required to test the resulting intervention model.

Keywords: cardiovascular disease; hypertension; diabetes; social risk; social intervention; social capital; social support; theory of change (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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