Feasibility and acceptability evaluation of a contextualised physical activity and diet intervention for hypertension control in rural South Africa

Kganetso Sekome, Hellen Myezwa, Francesc Xavier Gómez-Olivé., Dale Esliger, Lauren Sherar
Purpose:

The overall objective of this study is to evaluate the feasibility and acceptability of a contextualized physical activity and diet intervention for hypertension control in adults aged 40 years and older living in rural north-east South Africa.

Methods:

The intervention was designed through community stakeholder engagement, physical activity assessment, contextual analysis of dietary and physical activity participation, co-production, COM-B model of behaviour change framework. The intervention was a one-arm 10-weeks intervention. Feasibility was measured via assessing recruitment and retention rates. Acceptability was assessed through interviews after the 10 weeks intervention using pre-determined themes of perceived expectations, benefits, motivation, and barriers concerning the intervention. Fidelity was evaluated by intervention adherence, dosage, quality, and participant responsiveness.

Results:

Data collected to measure outcomes was complete. Our study demonstrated high level of feasibility, acceptability, and fidelity. Thirty (100% of target) participants were successfully recruited over two days, 28 (93%) participants were retained, and 28 (93%) provided complete data. Qualitative data demonstrated high acceptability through five themes: (1) meeting intervention expectations, (2) benefits of the intervention, (3) motivators to continue with intervention, (4) barriers associated with the intervention, and (5) suggestions for improvement. Overall satisfaction was rated using a Likert Scale which resulted in a rating of 8.5/10 being considered high satisfaction. Fidelity of the delivery of each component of the intervention was assessed by the primary investigator using the five dimensions of fidelity, namely: adherence, dosage, quality of intervention delivery, participant responsiveness, and program differentiation


Conclusion(s):

This was, to the authors’ knowledge, the first study in rural South Africa to determine whether adaptations in physical activity and diet based on existing daily routine would be feasible and acceptable by adults for the control of hypertension. Although deemed feasible and acceptable, some amendments are required to the intervention procedures that were carried out before a full trial can be rolled out. 

Implications:

This study shows that a contextually developed intervention for hypertension control has a promise of success, it encourages the rolling out into a larger trial. Similar contexts can adopt the intervention for use in clinical trials or community health promotion programs.

Funding acknowledgements:
funding obtained through CARTA and NRF Thuthuka.
Keywords:
high blood pressure
nutrition
physical activity
Primary topic:
Health promotion and wellbeing/healthy ageing/physical activity
Second topic:
Primary health care
Third topic:
Non-communicable diseases (NCDs) and risk factors
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
University of the Witwatersrand, Human Research Ethics Committee (HREC - Medical).
Provide the ethics approval number:
M 210282
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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