Prevalence and factors associated with inadequate work ability among community health workers in Montes Claros, Minas Gerais state, Brazil: a cross-sectional study, 2018
ABSTRACT Objective To estimate the prevalence and analyze factors associated with inadequate...
What did I learn?
First things first - great method. A good sample (675 participants), good screening tools: PHQ-9, IPAQ, IDTV, IGCT, Vigitel, RSE, and, at last, BMI to paint a broader sociodemographic landscape, perhaps. All validated to portuguese language, and all outcomes were dichotomized for statistics sake. On our own study of Estate Health Workers we also used PHQ-9 and there were some similarities, even though their sample consisted of community health workers only, and ours consisted of, basically, every health worker available at the district.
I liked the dichotomy, enjoyed reading their outcomes and discussion. I specially enjoyed when they explained the geographical context of Montes Claros:
This region represents a transition area between the most developed region in the country, the Southeast region, and the least developed region, the Northeast region, characterized by a vast territory of economic disparities.
They picked FHS teams for the sample, which is an interesting choice, once you understand the difference between common teams and FHS teams (and how this affects their will to work, their salary and their bond with the community).
Something to consider about their perspectives and final discussion, is the fact that maybe, for this especific goal, it would be even better to have a longitudinal study. It may sound obvious, but it was not for me until I read their reasoning: how will you actually understand prevalence and factors associated with inadequate work ability if you need to exclude them from your cross-sectional trials? They could not include people on leave, sick leave, reassigned due to pregnancy or other activities. Which makes sense - especially for people on sick leave! That would be a great example of inadequate work ability in display. It does not make the study poor, at all. But it leaves the door open for it to be deepened, just like ours (we made a cross-sectional study as well). I got excited while reading it, which made it all worth it.
They also displayed good examples of how we can dichotomize our results, my biggest concern was about our religion questions, since people had all kinds of different faith and practices. For an example, when they faced the ethniticy question, the results were: White or Black. Considering Brazils sociodemographical history, I liked that all people of color were put together. It feels like the best option here, but perhaps I would label the non-white option as simply Person Of Color (?) not sure which would be the best option, which feels odd since my job is to understand equity. But I guess it is nice to not have this question upfront, it leaves space to more research. And this will be my goal! To dichotomize that, I will suggest adding White and Something Dignified instead of simply Black.
One thing I personally loved was the Sun Exposure question. And the voice screening as well. Self-applied questionnaires can be great if you devote enough time to make them work, and I do believe that these authors poured a lot of their precious time into this study.
