**2.3 Practice**

HCPs are encouraged to support PLWNCDs in self-management of the condition by making changes in practice systems to accommodate these individuals. Group visits or support groups sessions could be arranged on scheduled times known to everyone who belongs to the group so that they can discuss on how they

**287**

*Self-Management Strategies to Curb the Development of NCDs in Rural Communities*

could self-manage their condition by getting advice from others who are in the similar situations. The HCPs could explain to PLWNCDs the disease management guidelines that could be used including patient reminders and to structure planned visits for review to suits the patients' time. A study about practice change in chronic condition care, encourages the use of theories, which must be adapted

Theory enables greater understanding of the relationships amongst factors that influence behavior change [6]. Theories which could be used. Health educational which contains behavior change are extra effective in the management of NCDs. Some of the theories which could be used in practice change includes Health Belief Model (HBF), Trans Theoretical Model (TTM) and Social Cognitive Theory (SCT). The HBF emphasizes that perceived threat as a motivating force and perceived benefits as offering desired course of action, while TTM views behavior change as a process wherein individual's progresses through a chain of awesome stages of change and lastly the SCT describes gaining knowledge as a reciprocal interaction between an individual's cognitive processes, environment and behavior (reciprocal

The PLWNCDs could be assisted with improving and controlling pain and mood through participation in programmes emphasizing four efficacy-enhancing strategies: mastery of skills through learning and practice, modeling by inspirational role leaders, encouraging participants to attempt more than they are currently doing and re-interpretation of symptoms to distinguish pain caused by the disease from those that caused by therapeutic interventions. NCDs require life-long self-management

The Department of Health could assist the PLWNCDs by creating a telephonic helpline where the calls could be answered and assist the PLWNCDs to manage the challenges such as symptoms they are experiencing at that moment prior going to the Primary Health Care Clinic. These telephonic helplines can also assist in clarifying issues like how to take treatment when they have forgotten the medication instructions. It has been found that the use of telephone-based patient self-management of chronic diseases is more cost-effective way to minimize healthcare expenditures [10].

**3. Billboards, pamphlets, educational booklets, posters and radio talks**

The Department of Health (DoH) and also HCPs have equal responsibilities in making sure that health messages which include health advise reach to individuals in need including PLWNCDs. The DoH has a responsibility of making sure that health messages are placed on billboards which are believed to be influential platform to educate people on health issues. The HCPs professionals have to write Pamphlets, Educational Booklets and Posters which can convey health messages to PLWNCDs. The pamphlets and educational booklets could be distributed at the Primary Health Care clinics and also at local shops and saloons whilst the posters could be displayed on notice boards at the clinics and also on poles along the streets. These will encourage everyone to read through as long as they are visible. Old PLWNCDs who cannot read and write can also request the children whom they are living with to read through for them. All these Billboards, Pamphlets,

*DOI: http://dx.doi.org/10.5772/intechopen.96222*

with regular HCPs' support and supervision [7–9].

and supplemented [5].

determinism).

**2.4 Community**

**2.5 Telephonic helpline**

*Self-Management Strategies to Curb the Development of NCDs in Rural Communities DOI: http://dx.doi.org/10.5772/intechopen.96222*

could self-manage their condition by getting advice from others who are in the similar situations. The HCPs could explain to PLWNCDs the disease management guidelines that could be used including patient reminders and to structure planned visits for review to suits the patients' time. A study about practice change in chronic condition care, encourages the use of theories, which must be adapted and supplemented [5].

Theory enables greater understanding of the relationships amongst factors that influence behavior change [6]. Theories which could be used. Health educational which contains behavior change are extra effective in the management of NCDs. Some of the theories which could be used in practice change includes Health Belief Model (HBF), Trans Theoretical Model (TTM) and Social Cognitive Theory (SCT). The HBF emphasizes that perceived threat as a motivating force and perceived benefits as offering desired course of action, while TTM views behavior change as a process wherein individual's progresses through a chain of awesome stages of change and lastly the SCT describes gaining knowledge as a reciprocal interaction between an individual's cognitive processes, environment and behavior (reciprocal determinism).

#### **2.4 Community**

*Lifestyle and Epidemiology - The Double Burden of Poverty and Cardiovascular Diseases...*

their quality of life [2], whilst such centres do not exist in the Low Income and Middle Income countries poor communities. Therefore, this chapter is aimed at explaining various self-management strategies that PLWNCDs could use in rural communities to raise awareness and as a means of providing information about

It has been observed that mostly PLWNCDs in rural communities have limited knowledge when it comes to self-management of the disease including NCDs. The basic things which they understand and believe in is mostly the traditional herbs which might be used to curb the diseases' signs and symptoms. There is lack of knowledge on the lifestyle that communities and PLWNCDs could adhere to in order to minimize predisposing factors and also complications of NCDs. They lack knowledge on the type of diet, exercises they must engage in and the fact that they must avoid excessive alcohol intake and cigarette smoking. The identified lack of knowledge in managing the diseases calls for provision of basic health education at all levels of care especially at primary health care level in order to target rural communities where the problems has been identified. The following has to be included

The HCPs professionals have to use motivational counseling whenever they are consulting or interviewing the PLWNCDs. They should not use directive questions but make sure that the questions asked encourages the PLWNCDs to take part in planning for the health care intervention so that they have that feeling which indicates that they are fully participating in their care and are listened to by HCPs who will be encouraging them to participate and make calculated decisions. This interviewing style of asking the PLWNCDs provocative questions and discussing their responses, often helps uncover important self-management issues and has been proven that is effective in preventing relapse in patients as they will be part of the decision-making process. Motivational interview interventions have been found to be effective in enhancing adherence to intake of chronic diseases medication [3].

The PLWNCDs will be assisted to be able to identify barriers that could be common to impede successful self-management of the disease. Mostly the barriers that exist are co-morbidities which aggravates the existing condition which needs to be self-managed. Therefore, it means that self-management strategies developed with the assistance of the HCPs must include on how to also manage the co-morbidities. A Mixed Method United States study investigating barriers to chronic disease reporting in public schools reported that improving parental education will help in

HCPs are encouraged to support PLWNCDs in self-management of the condition by making changes in practice systems to accommodate these individuals. Group visits or support groups sessions could be arranged on scheduled times known to everyone who belongs to the group so that they can discuss on how they

**2. Knowledge of PLWNCDs in managing the condition**

management of the diseases.

in the health education programme:

improving chronic disease reporting [4].

**2.1 Motivational interview**

**2.2 Identifying**

**2.3 Practice**

**286**

The PLWNCDs could be assisted with improving and controlling pain and mood through participation in programmes emphasizing four efficacy-enhancing strategies: mastery of skills through learning and practice, modeling by inspirational role leaders, encouraging participants to attempt more than they are currently doing and re-interpretation of symptoms to distinguish pain caused by the disease from those that caused by therapeutic interventions. NCDs require life-long self-management with regular HCPs' support and supervision [7–9].

#### **2.5 Telephonic helpline**

The Department of Health could assist the PLWNCDs by creating a telephonic helpline where the calls could be answered and assist the PLWNCDs to manage the challenges such as symptoms they are experiencing at that moment prior going to the Primary Health Care Clinic. These telephonic helplines can also assist in clarifying issues like how to take treatment when they have forgotten the medication instructions. It has been found that the use of telephone-based patient self-management of chronic diseases is more cost-effective way to minimize healthcare expenditures [10].

### **3. Billboards, pamphlets, educational booklets, posters and radio talks**

The Department of Health (DoH) and also HCPs have equal responsibilities in making sure that health messages which include health advise reach to individuals in need including PLWNCDs. The DoH has a responsibility of making sure that health messages are placed on billboards which are believed to be influential platform to educate people on health issues. The HCPs professionals have to write Pamphlets, Educational Booklets and Posters which can convey health messages to PLWNCDs. The pamphlets and educational booklets could be distributed at the Primary Health Care clinics and also at local shops and saloons whilst the posters could be displayed on notice boards at the clinics and also on poles along the streets. These will encourage everyone to read through as long as they are visible. Old PLWNCDs who cannot read and write can also request the children whom they are living with to read through for them. All these Billboards, Pamphlets,

Educational Booklets and Posters must also be written in local language. The DoH has to approach local radio stations to provide slots where HCPs could be able to reach out communities to provide Health Education on NCDs. These sessions must also have questions and answers sessions where listeners could be provided with an opportunity to ask questions where they could be provided with an opportunity to be clarified on issues they do not understand as far as NCDs are concerned. It has been found that the use of mass media campaigns can change health behaviors of the people in line with the communicated message [11].
