Browsing by Author "Oyore, John P."

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    Activation in Cancer Survivorship in Kenya: Results of a Cluster-Randomized Trial
    (Journal of Clinical Nursing & Reports, 2024-07) Mchidi, Nebert K.; Oyore, John P.; Ogweno, Gordon
    Introduction: Kenya’s cancer situation, as in the rest of the developing world, is marred by treatment access deficiencies arising from multiple foci in the continuum of health care that make survival difficult. These challenges, stemming from patient, service, and service provider points of view, place the patient at an increasing need for continuous support through the survivorship. This study, aimed at improving the patient’s knowledge, skills, and confidence in self-care; and has been conceptualized as activation. Data on patient activation have demonstrated the positive influence of activation on different survivorship outcomes, including symptom management, adherence, and improved quality of life. In Kenya, there is a dearth of data on the utility of SMS interventions to shape patient activation, particularly for cancer. Methods: This multisite study evaluated the effectiveness of mobile phone SMS support on patient activation among adult cancer patients in Kenya. Specifically, the study sought to determine the influence of individual factors and the intervention on patient activation. Data were collected using questionnaires. Ethical approval was obtained from the Kenyatta University Ethics Review Committee and various Hospital Ethics Review Boards. A permit to conduct the study was obtained from the National Commission for Science, Technology, and Innovation (NACOSTI), while consent was obtained from individual participants. A DSMB was formed to address any SAE of the study. Results: The mean age of the participants was 52.9 ±12.9 years. Most of the participants reported delayed initiation of cancer treatment. Furthermore, the majority, 56.9% (n = 230), of the participants were activated in care. The majority of 95.7% (n-=220) of those activated in care were in the intervention arm and this was statistically significant (χ²dd = 326.550, p=<0.001). Conclusions: the SMS support intervention has shown superiority in influencing patient activation and several demographic factors have a significant influence on patient activation. There is a need to redesign the initiation of cancer treatment to prevent delayed initiation of treatment.
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    Performance of community health workers in Njiru District, Nairobi County, Kenya
    (medicalsciencejournal, 2016) Mulingwa, Margaret W.; Cheboi, Solomon K; Oyore, John P.; Ochien’g, Otieno G.
    In 2006, World Health Organization report recognized shortages of health workers as an ingredient in primary health services. In mitigation the Alma-Ata declaration of 1978 promoted the use of Community Health Workers (CHWs) to provide selected services at level one of health care services. In Kenya, CHWs workforce were adopted as a component of cost effective strategies however the performance of CHWs as change agents has been called into question. The study aimed at describing the factors which influence performance of CHWs in Njiru District, Nairobi County, Kenya through a descriptive cross-sectional survey. Mixed methods (quantitative and qualitative methods) and systematic sampling method were applied. Data was analyzed using Statistical Package for Social Science (SPSS) version 20.0. Findings showed that performance of CHWs was low (34.7%). The performance of CHWs was low in four key monthly targets (referral of patients; number of houses visited; CHWs meetings; number of Baraza but average in health education. Age, gender, marital status, community reception, religious practices, cultural norms, use of feedback, period of training, field allowance and social class were key factors in CHWs performance. From this study the implementation and realization of the key CHWs targets in Peri- urban setting is challenging, there is need therefore to develop a clear contextualized CHWs guideline tailored for Peri- urban settings.