Behaviour change in chronic respiratory disease patients through health care worker delivered theory of planned behaviour-based educational intervention: results from a pilot feasibility study

Abstract

Introduction: Chronic respiratory diseases (CRDs) are often neglected and poorly diagnosed, leading to missed opportunities for treatment and poor patient pathways, especially in poor rural regions of India. There is typically poor understanding in rural communities of the causes of respiratory illness and appropriate treatment. Theory of planned behaviour (TPB)-based health interventions have been used in chronic diseases to change health behaviour. The aim of the study was to determine the change in health behaviour in patients with CRD following TPB-based intervention.

Methods: 100 participants each in the intervention arm (IA) and control arm (CA) were recruited. All participants were started on inhalers with spacers, with respiratory exercise demonstration and a pictorial handout about CRD. IA received health care worker delivered, TPB-based educational intervention which included live puppet shows and video shows; heath belief model-based education was given in the CA.

Results: We found that there was significant improvement in the compliance to inhaler use (p<0.001) and respiratory exercises (p<0.001) and decrease in biomass fuel use (p<0.001) in both arms. There was significant improvement in subjective norms about CRD care (p<0.05) and perceived behavioural control over risk reduction and accessing care (p<0.05) among participants in both arms.

Conclusion: Community education and structured follow-up of patients can by itself bring about a change in behaviour with regards to risk reduction and accessing care in patients with CRD irrespective of type of education given.