Browsing by Author "Kushitor, S.B."
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Item Building cardiovascular disease competence in an urban poor Ghanaian community: A social psychology of participation approach(Journal of Community & Applied Social Psychology, 2020-01-08) Aikins, A.D-G.; Kushitor, M.; Kushitor, S.B.; Sanuade, O.; Asante, P.Y.; Sakyi, L.This paper describes conceptual, methodological, and practical insights from a longitudinal social psychological project that aims to build cardiovascular disease (CVD) competence in a poor community in Accra, Ghana's capital. Informed by a social psychology of participation approach, mixed method data included qualitative interviews and household surveys from over 500 community members, including people living with diabetes, hypertension, and stroke, their caregivers, health care providers, and GIS mapping of pluralistic health systems, food vending sites, bars, and physical activity spaces. Data analysis was informed by the diagnosis-psychosocial intervention-reflexivity framework proposed by Guareschi and Jovchelovitch. The community had a high prevalence of CVD and risk factors, and CVD knowledge was cognitive polyphasic. The environment was obesogenic, alcohol promoting, and medically pluralistic. These factors shaped CVD experiences and eclectic treatment seeking behaviours. Psychosocial interventions included establishing a self-help group and community screening and education. Applying the “AIDS-competent communities” model proposed by Campbell and colleagues we outline the psychosocial features of CVD competence that are relatively easy to implement, albeit with funds and labour, and those that are difficult. We offer a reflexive analysis of four challenges that future activities will address: social protection, increasing men's participation, connecting national health policy to community needs, and sustaining the project.Item Development of a Facilitator Guide for Nutrition Education on Overweight and Obesity in the Eastern Region of Ghana(African Journal of Food, Agriculture and Development, 2023) Kushitor, S.B.; Colecraft, E.K.Overweight and obesity are global public health problems. Although overweight and obesity are high in urban areas, the prevalence of overweight and obesity is increasing steadily in rural areas. However, interventions to address overweight and obesity in rural areas are limited. This study reports on the process of developing a facilitator guide for a nutrition education program on overweight and obesity in rural Ghana. The transtheoretical model guided this study. The study was conducted in three districts in the Eastern Region of Ghana. The facilitator guide was developed according to the Food and Agriculture Organisation’s (FAO) guidelines for planning community nutrition education. This study engaged nutrition and agricultural officers working in the study area and academics through an iterative process to draft, revise, and design the facilitator guide. The procedures included a desk literature review, analysis of secondary data, telephone interviews, a seminar and two workshops. The guide consists of five lessons. Lesson 1 creates an awareness of overweight and obesity by providing a definition and the Stunkard Figure Rating Scale. It also includes data on the prevalence of overweight and obesity and abdominal obesity of women in the study area. Lesson 2 discusses body image perceptions and their association with overweight and obesity. Lesson 3 highlights the economic, social and health consequences of overweight and obesity. Lesson 4 explains the four-star diet and how to achieve it. The lesson includes a description of each star of the four-star diet with local examples. Lesson 5 discusses physical activity and steps to increase physical activity. Each lesson ends with a key message. Songs were developed for Lessons 3, 4 and 5. This study describes the process of developing a facilitator guide for overweight and obesity education at the community level. The guide can be used to raise awareness of overweight and obesity and weight managementItem Dietary patterns among adults in three low income urban communities in Accra, Ghana(PLOS ONE, 2023) Kushitor, S.B.; Alangea, D.O.; Aryeetey, R.; Aikins, A-d-GObjective Dietary patterns describe the dietary behaviour and habits of individuals. Unhealthy dietary patterns provide individuals with limited nutrients while increasing the risk of nutrition-related diseases. Unhealthy dietary patterns are high in urban areas, especially among low-income urban residents. This study examined dietary patterns in three low-income urban communi ties in Accra, Ghana, between 2011 and 2013. Methods This study used Wave 2 and 3 data from the Urban Health and Poverty Survey (EDULINK 2011 and 2013). The sample size was 960 in 2011 and 782 in 2013. Dietary pattern was examined using factor analysis and the NOVA food classification system. Summary statis tics were computed for sociodemographic characteristics and diet frequency and pattern. Differences in dietary behaviours between 2011 and 2013 were also estimated. Three logis tic regression models were computed to determine the predictors of dietary patterns. Results The frequency of consumption of animal-source foods (ASF) and fruits was higher in 2013 compared with 2011. The intake of processed culinary ingredients (NOVA Group 2), pro cessed foods (NOVA Group 3) and ultra-processed foods (NOVA Group 4) was higher in 2013 versus 2011. In 2013, 29% consumed ultra-processed foods compared to 21% in 2011. Three dietary patterns (rice-based, snack-based, and staple and stew/soup) were identified. About two out of every five participants consumed the food items in the rice (43%) and staple and sauce patterns (40%). The proportion of participants who consumed the food items in the snack pattern was 35% in 2011 but 41% in 2013. Respondents aged 25– 34 and those with higher education often consumed the snack-based and rice-based dietary patterns. In 2013, participants in Ussher Town had a higher probability of consuming food items in the snack pattern than those living in Agbogbloshie.Conclusions This study found that between 2011 and 2013, more participants consumed ASFs, fruits, and processed foods. A complex interplay of personal and socio-cultural factors influenced dietary intake. The findings of this study mirror global changes in diet and food systems, with important implications for the primary and secondary prevention of NCDs. Health promotion programs at the community level are needed to address the increasing levels of processed food consumption.Item Institutional mortality rate and cause of death at health facilities in Ghana between 2014 and 2018(PLOS ONE, 2021) Owusu, A.Y.; Kushitor, S.B.; Ofosu, A.A.; Kushitor, M.K.; Ayi, A.; Awoonor-William, J.K.The epidemiological transition, touted as occurring in Ghana, requires research that tracks the changing patterns of diseases in order to capture the trend and improve healthcare delivery. This study examines national trends in mortality rate and cause of death at health facilities in Ghana between 2014 and 2018. Institutional mortality data and cause of death from 2014–2018 were sourced from the Ghana Health Service’s District Health Information Management System. The latter collates healthcare service data routinely from government and non-governmental health institutions in Ghana yearly. The institutional mortality rate was estimated using guidelines from the Ghana Health Service. Percent change in mortality was examined for 2014 and 2018. In addition, cause of death data were available for 2017 and 2018. The World Health Organisation’s 11th International Classification for Diseases (ICD-11) was used to group the cause of death. Institutional mortality decreased by 7% nationally over the study period. However, four out of ten regions (Greater Accra, Volta, Upper East, and Upper West) recorded increases in institutional mortality. The Upper East (17%) and Volta regions (13%) recorded the highest increase. Chronic non-communicable diseases (NCDs) were the leading cause of death in 2017 (25%) and 2018 (20%). This was followed by certain infectious and parasitic diseases (15% for both years) and respiratory infections (10% in 2017 and 13% in 2018). Among the NCDs, hypertension was the leading cause of death with 2,243 and 2,472 cases in 2017 and 2018. Other (non-ischemic) heart diseases and diabetes were the second and third leading NCDs. Septicaemia, tuberculosis and pneumonia were the predominant infectious diseases. Regional variations existed in the cause of death. NCDs showed more urbanregion bias while infectious diseases presented more rural-region bias. Conclusions This study examined national trends in mortality rate and cause of death at health facilities in Ghana. Ghana recorded a decrease in institutional mortality throughout the study. NCDs and infections were the leading causes of death, giving a double-burden of diseases. There is a need to enhance efforts towards healthcare and health promotion programmes for NCDs and infectious diseases at facility and community levels as outlined in the 2020 National Health Policy of Ghana.