Respiratory Health in Los Robles, Nicaragua: A curriculum and facilitation guide for community health workers Open Access

Moya, Claudia Maria (2017)

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Background: Despite recent declines in mortality, respiratory diseases continue to be a problem for rural populations of Nicaragua. Community health workers known as brigadistas voluntarily work in health promotion activities at the community level but they lack consistent, standardized training. Los Robles, a community in Jinotega, has 15 brigadistas that work alongside a partner non-governmental organization--the Nicaragua Community Health Connection (NCHC). Brigadistas, along with other stakeholders, identified respiratory health as the most pertinent health issue afflicting the community. Further, brigadistas shared that they had received little formal training on respiratory health.

Purpose: The purpose of this special studies project was to create a uniform resource that equipped brigadistas with basic respiratory health knowledge including anatomy, common illnesses, and prevention, and also built self-efficacy of brigadistas by providing guidance for facilitation through suggested interactive activities.

Methods: The development of the guide was informed by a review of the literature that encompassed existing curricula and training manuals and participatory learning methods and theory, one focus group discussion, pre- and post-tests on respiratory health knowledge and self-efficacy levels, and 15 key informant interviews.

Results: The literature review provided useful examples of curricula and manuals as well as successful applications of participatory learning methods and theory. The qualitative findings suggested that brigadistas favor participatory learning methods in small group settings and found the capacity building sessions useful in their educational and personal development. Additionally, brigadistas provided helpful suggestions to guide the structure and design of the guide. The respiratory health knowledge pre- and post-tests implied that there was improvement before and after the capacity building sessions but several unknowns are associated with these results and cannot be considered accurate. Similarly, self-efficacy levels were assessed through a pre-test only and therefore, it cannot be determined if self-efficacy levels changed. Ultimately, the final guide includes four modules with topics ranging from basic anatomy to prevention strategies.

Discussion: It is my hope that brigadistas will host educational sessions using this guide and encourage community members to adopt health behaviors and preventive strategies. By doing so, Los Robles may experience a reduction in respiratory-health related clinic visits.

Table of Contents

Table of Contents

Chapter 1: Introduction... 1

1.1 Background and Rationale...1

1.2 Problem Statement...2

1.3 Purpose Statement...4

1.4 Objectives...4

1.5 Significance...5

1.6 Definition of Terms and Acronyms...5

Chapter 2: Review of the Literature...7

2.1 Introduction...7

2.2 Existing Curricula and Training Manuals...8

2.3 Participatory Learning Methodologies and Theories...11

2.4 Summary and Special Studies Project Relevance...15

Chapter 3: Methods...16

3.1 Introduction...16

3.2 IRB Approval...16

3.3 Focus Group Discussion Methods...17

3.4 Capacity Building Sessions...17

3.5 Key Informant Interview Methods...19

Chapter 4: Results...20

4.1 Introduction...20

4.2 Focus Group Discussion Results...20

4.3 Pre and Post Test Results...23

4.4 Key Informant Interview Results...26

4.5 Curriculum and Facilitation Guide...31

Chapter 5: Discussion...32

5.1 Introduction...32

5.2 Limitations and Strengths...32

5.3 Recommendations...36

5.4 Conclusion...38



Appendix A: Focus Group Discussion Guide...44

Appendix B: Key Informant Interview Guide...45

Appendix C: Pre and Post Tests...45

Appendix D: Curriculum and Facilitation Guide...49

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