The lesson of Monsieur Nouma: effects of a culturally sensitive communication tool to improve health-seeking behavior in rural Cameroon

Patient Educ Couns. 2012 Jun;87(3):343-50. doi: 10.1016/j.pec.2011.11.007. Epub 2011 Dec 29.


Objective: To test the effect of patient counseling using educational tools, on rates of return for follow-up in newly diagnosed hypertensive and/or diabetic patients in a rural African context.

Methods: Free screening for hypertension and elevated blood glucose was offered in primary health care centers in central Cameroon during 9 campaigns of 3 days each. Individuals with untreated hypertension and/or diabetes were divided into 2 groups: a control group receiving counseling according to routine procedures, and an intervention group receiving counseling with different educational tools to explain the diagnosis and its implications to the patient.

Results: Prevalence of hypertension and/or diabetes in the screened population was 41%. At 3 months from screening, rates of return visits were higher in the intervention group than in the control group: 55/169 (32%) vs. 15/92 (16%), OR 2.4; 95%CI 1.3-4.7; p<0.001.

Conclusion: Screening may identify untreated individuals efficiently. Rates of return visits after screening, although low in both groups, could be doubled by a short communication intervention.

Practice implications: This study suggests that modest communication interventions, e.g., the application of educational tools, may bring important benefits and increase the effectiveness of public health measures to combat chronic diseases in settings of limited resources.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Black People
  • Cameroon / epidemiology
  • Communication*
  • Counseling / methods*
  • Culture
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / ethnology
  • Diabetes Mellitus / psychology
  • Female
  • Follow-Up Studies
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / ethnology
  • Hypertension / psychology
  • Logistic Models
  • Male
  • Mass Screening
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Patient Acceptance of Health Care*
  • Patient Education as Topic
  • Prevalence
  • Primary Health Care
  • Rural Population
  • Socioeconomic Factors