ABSTRACT
OBJECTIVES: To examine changes in self-reported arthritis-related illness and self-rated health as a result of a health education intervention, and the association between self-reported arthritis-related illness and self-rated health. STUDY DESIGN: A quasi-experimental study was conducted in eight randomly selected villages in rural Bangladesh (intervention = 4; control = 4). METHODS: The intervention consisted of home-based physical activities, health advice and aspects of healthcare management over 15 months followed by a 3-month latent period. Data were collected before the intervention and after the latent period. Analyses included 839 participants (≥60 years of age) who participated in both surveys. Participants in the intervention area were further categorized into two groups who self-reported compliance or non-compliance with recommended health advice. Self-rated health was assessed using a single global question. Self-reported arthritis-related illness was indicated by the presence of arthritis, back and joint pain, biting sensation, swelling and inflammation in the joints. RESULTS: Hierarchical logistic regression analyses revealed that positive effects on episodes of arthritis-related illness [odds ratio (OR) 1.9, 95% confidence interval (CI) 1.3-2.8] and self-rated health (OR 1.4, 95% CI 1.0-1.9) were more likely among the compliant group compared with the control group. Furthermore, positive self-rated health was more likely among participants reporting a positive change in their arthritis-related illness (OR 2.2, 95% CI 1.5-3.2). The results also showed that literate and non-poor participants were more likely to report positive health, and participants with advancing age were less likely to report positive health. CONCLUSION: Community-based health education is effective in reducing the burden of arthritis-related illness and in enhancing general health in old age.
Subject(s)
Arthritis/epidemiology , Diagnostic Self Evaluation , Health Education , Rural Population/statistics & numerical data , Acute Disease/epidemiology , Acute Disease/psychology , Aged , Arthralgia/complications , Arthralgia/epidemiology , Arthralgia/psychology , Arthritis/psychology , Back Pain/complications , Back Pain/epidemiology , Back Pain/psychology , Bangladesh , Female , Health Status , Health Surveys , Humans , Logistic Models , Male , Middle Aged , Odds RatioABSTRACT
This study examines the impact of health education on prevalence of and expenditure on treatment of self-reported arthritis-related illness among elderly persons in rural Bangladesh. An intervention study was conducted, including 1135 elderly persons (>or=60 years) from eight randomly selected villages, four each of an intervention and a control area. The analyses include 839 elderly persons who participated in both pre- and post-intervention surveys (intervention area: n = 425, control area: n = 414). Participants of the intervention area were further categorized as compliant (n = 315) and non-compliant (n = 110) based on adherence to the intervention instructions. The intervention that lasted for 15 months comprised home-based physical exercise, dietary instructions and other aspects of management. Results show that although there was no significant difference in self-reported arthritis-related illness between the compliant and non-compliant groups at baseline, it was significantly lower in the compliant group (71%) at post-intervention compared with the non-compliant (81%). Related monthly expenditure on treatment was significantly reduced in the compliant group (from Taka 104 to Taka 52) but not in the other two groups. Logistic regressions further showed that the control group had a higher probability of increased treatment-related expenditure compared with the compliant group (OR 2.0, 95% CI 1.4-2.8).
