Stroke Prevention: Exploring the Knowledge, Attitudes and Practices of CHWs and Healthcare Professionals in the North-West Province, South Africa.

Abstract

Background: Stroke is a major global health issue, often preventable with early intervention. Community health workers (CHWs) are vital in primary care and prevention, yet their role in cardiovascular care, particularly stroke prevention, in South Africa is under-researched. Further research is needed to understand their knowledge, attitudes, and practices towards stroke prevention. Objectives: Objectives of this study included: (1) To explore and describe community health workers' knowledge, attitudes and practices towards stroke prevention for individuals at risk of cardiovascular disease; (2) To explore and describe healthcare professionals' perceptions of the knowledge, attitudes and practices community health workers should have to prevent strokes. Methods: A qualitative, exploratory and descriptive design was followed. Purposive sampling of community health workers, healthcare professionals and community health centres was used. Eight World Café sessions with community health workers (n= 90) and eight focus group discussions with healthcare professionals (n = 49) were held. Cresswell's six steps of thematic analysis were used. Results: From the World Café sessions and the focus group discussions, three themes with respective subthemes emerged, namely (1) Knowledge, (2) Attitudes and (3) Practices, which mostly corresponded with each other. The data from the focus group discussions were more specific and clinical, owing to the nature of the healthcare professionals' responses. Discussion: Under the 'knowledge' theme, gaps/misconceptions were identified with regard to Community Health Workers' stroke prevention knowledge. The 'attitude' theme revealed that Community Health Workers displayed positive and negative attitude influencers, contributing to or hindering their ability to practice stroke prevention. The 'practice' theme revealed that stronger emphasis should be placed on identifying patients at risk and eliminating myths/misconceptions, stressing continued training. Conclusion: Community health workers can play a significant role in stroke prevention if they are equipped with the needed knowledge, attitudes, and practices. A unique finding is that myths and misconceptions regarding stroke exist among community health workers and should be addressed to practise effective stroke prevention.