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Engaging communities to prevent disease
A broader approach to healthcare
Building healthy communities is about more than medicine. It requires informed communities who are empowered to seek and access appropriate healthcare.
For years, University of Sydney Vietnam Institute research staff have partnered with University of Sydney researchers and partner institutions to better understand the role of communities in preventing disease.
In Vietnam, where an ageing population, increased demands on the healthcare system, and the impacts of COVID-19 create unique health challenges, these findings have helped to influence policy, guide disease response, and support new healthcare initiatives.
Ensuring an accessible healthcare system
Extensive clinical trials are informing healthcare guidelines
Patients suffering from chronic diseases require access to effective and timely treatments. The Vietnam COPD, Asthma and Prevention of Smoking (VCAPS) study demonstrated the effectiveness and feasibility of integrated approaches to chronic lung disease prevention and treatment across four provinces of Vietnam.
Lead researchers included Professor Greg Fox from the University of Sydney, Professor Guy Marks from the University of New South Wales, and Professors Vu Van Giap and Ngo Quy Chau from Bach Mai Hospital, partnering with the Woolcock Institute and Hanoi Medical University. They worked with four provincial health departments to better understand how patients were accessing healthcare. The study combined clinical trials, surveys, and qualitative studies.
The researchers found that among patients with chronic obstructive pulmonary disease (COPD) and asthma, the path to diagnosis and treatment were complex. Patients often lacked knowledge about their condition. Social and financial support was often limited.
With the final findings to be released later in 2024, the study results will play a significant role in improving care for patients. Not only relevant to Vietnam, these findings also will improve care of patients in other resource-limited settings around the world.
Understanding attitudes towards smoking
Tobacco smoking is a leading cause of premature death, and smoking prevalence in Vietnam ranks among the highest in Southeast Asia. The VCAPS tobacco control study enabled researchers to examine smoking behaviours, potential health implications, and cessation supports in Vietnam.
By surveying current smokers presenting to health facilities across Vietnam, researchers showed that smokers who were counselled to quit by healthcare providers were more likely to make quit attempts. According to researcher Professor Vu Van Giap, Deputy Director, Bach Mai Hospital, current cessation aids including counselling and nicotine replacement therapy have limited uptake.
"While the current uptake of cessation aids is low, healthcare workers play a crucial role in supporting smokers to quit. These low-cost interventions can contribute to a reduction in smoking prevalence in Vietnam", said Professor Vu Van Giap.
By understanding both community attitudes towards smoking, as well as the importance of health care providers in encouraging smoking cessation, researchers are working towards more efficient smoking cessation support methods. The effectiveness of a free quit-line for smokers will be examined when the full findings of the VCAPS study are released later in 2024.
Vaccines and COVID-19 stigma
Community attitudes played and continue to play a significant role in both vaccine uptake and public responses to COVID-19. From 2020 onwards, University of Sydney researchers have guided government response to COVID-19 and communications to best engage communities.
When COVID-19 cases started to increase in Vietnam, public stigma around COVID-19 also grew. By collecting qualitative data, researchers found that this stigma risked impacting the public’s willingness to engage in testing and diagnosis.
The researchers suggested strategies to mitigate harmful COVID-19 stigma while supporting overall prevention of the disease. Distancing infection risk from behaviour has the potential to position those who engage in testing and diagnosis as responsible, instead of placing blame on individuals who test positive.
For example, mass testing could reduce the association of a COVID-19 diagnosis as a marker of individual behaviour and present it as a collective community risk.
University of Sydney researchers have also partnered with Institute research staff to combat apprehension to continue uptake of COVID-19 vaccinations. After vaccine supplies stabilised, the main issue became one of vaccine update, according to University of Sydney Vietnam Institute Director and infectious disease researcher Professor Thu-Anh Nguyen.
"As reports started to suggest that newer variants caused more mild disease, people were less concerned and thought they didn’t need a third vaccine dose", said Professor Nguyen.
"At the same time, information and rumours circulated about adverse reactions to the vaccine, and some people no longer wanted to have it".
Qualitative research in this area supported better targeting of vaccines for high-risk populations and improved communication to reduce stigma and improve testing.
Researchers from the University of Sydney are now partnering with Institute research staff to continue the work to strengthen vaccine access and uptake through research project Australian Expert Technical Assistance Program for Regional COVID-19 Vaccine Access: Policy, Planning and Implementation (AETAP-PPI).
Working with the Ministry of Health and the National Institute of Hygiene and Epidemiology, the project aims to:
- Increase COVID-19 vaccine uptake and improve related communication,
- Develop effective vaccine communication strategies, materials and training plans,
- Provide trainers and materials for Ministry of Health and UNICEF training, and
- Provide technical advice to Vietnam's National Technical Advisory Group (NITAG).
With unique capabilities to combine clinical trials and qualitative research, the Institute continues to deliver high-quality research to empower communities to access timely and effective healthcare.