Integrated Community Analysis Transformation (ICAT) Model: A Tool for Community NCD Prevention and Improved Quality of Life

Author(s): Christopher Ddamulira, Stephen S. Kizza, Eria Muwanguzi, James Wanzima, Lawrence Sserwanga, Frank Pio Kiyingi

Purpose: To develop a model that would be used to address Non-Communicable Diseases (NCDs) in communities for the improvement of the quality of life of People with HIV living with Hypertension and Diabetes.

Methods: A cross-sectional survey was conducted in Wakiso, Uganda, among HIV patients receiving antiretroviral therapy and drug refills from CDDP. 219 participants completed questionnaires. Data was analyzed using Pearson’s product-moment correlation, simple linear regression, path analysis, and structural equation modeling (SEM) techniques to validate and assess the model.

Results: Community-based NCD services, such as health promotion (β=0.58, P=0.006), community support systems (β=0.24, P=0.000), and patient monitoring systems (β=0.46, P=0.000), had a direct impact on quality of life. The moderating effect revealed both significant (marital status, education level, and NCD services) and insignificant (age and gender) direct and indirect pathways.

Conclusion: The structural equation modeling and path analysis results showed that community support systems, patient factors, and patient monitoring systems as direct effects had weak loadings on patients’ quality of life. The model fitted perfectly, according to the goodness of fit test's overall indicators. Therefore, to boost service use and enhance patients' overall quality of life, the government, together with the Ministry of Health and District Health Officers, should put the ICAT model into practice.