Uptake of Task-Strengthening Strategy for Hypertension (TASSH) control within Community-Based Health Planning Services in Ghana: study protocol for a cluster randomized controlled trial.
Uptake of Task-Strengthening Strategy for Hypertension (TASSH) control within Community-Based Health Planning Services in Ghana: study protocol for a cluster randomized controlled trial.
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加纳社区卫生计划服务中高血压控制任务强化策略（TASSH）的应用：一项随机分组对照试验的研究方案
DOI：
10.1186/s13063-020-04667-7
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发表时间：
2020-10-02
期刊：
影响因子：
2.5
通讯作者：
Plange-Rhule J
中科院分区：
文献类型：
--
作者：
Asante KP;Iwelunmor J;Apusiga K;Gyamfi J;Nyame S;Adjei KGA;Aifah A;Adjei K;Onakomaiya D;Chaplin WF;Ogedegbe G;Plange-Rhule J
医生短缺是加纳控制高血压 (HTN) 的一个主要障碍，2015 年只有一名医生负责治疗 10,000 名患者，从而限制了其在初级保健层面控制高血压的能力，例如大多数加纳人接受护理的社区健康规划和服务 (CHPS) 院落。基于世界卫生组织心血管 (CV) 风险包的高血压控制任务转移策略 (TASSH) 是一种基于证据的策略，旨在减轻提供者和系统层面实现最佳高血压控制的障碍。尽管 TASSH 非常有效，但尚未在 CHPS 区域进行测试。此外，低收入和中等收入国家（LMIC）的初级保健实践缺乏在没有援助的情况下协调多层次系统变革所需的资源和专业知识。拟议的研究将评估实践促进 (PF) 作为在加纳 CHPS 区内实施 TASSH 的质量改进策略的有效性。在实施研究综合框架和范围、有效性、采用、实施和维护框架的指导下，我们将在混合临床有效性-实施设计中，在 70 名患有不受控制的 HTN 的 CHPS 区域的 700 名成年人中，评估 PF 对采用循证 TASSH 的影响。 PF 战略的组成部分包括 (a) 一个咨询委员会，为在 CHPS 区域内实施干预措施提供领导支持；(b) 训练有素的任务强化促进者 (TSF)，他们充当实践教练，向将在 CHPS 区域实施 TASSH 的社区卫生官员 (CHO) 提供培训和绩效反馈。为此，TSF 接受培训，负责识别、咨询患有未受控制的高血压的成年人，并将其转诊至加纳博诺东部地区的社区卫生中心。加纳迫切需要采用基于社区的循证干预措施来控制高血压，以解决心血管疾病的流行及其相关的发病率、死亡率和社会成本。这项研究的结果将为政策制定者和其他利益相关者提供关于加纳采用基于证据的任务强化干预措施控制高血压的“如何去做”的实证文献，并将作为其他低收入、中等收入国家类似行动的典范。 ClinicalTrials.gov，NCT03490695。注册于 2018 年 4 月 6 日。版本 1，日期：2019 年 8 月 21 日。
Physician shortage is a major barrier to hypertension (HTN) control in Ghana, with only one physician to 10,000 patients in 2015, thus limiting its capacity for HTN control at the primary care level such as the Community Health Planning and Services (CHPS) compounds, where most Ghanaians receive care. A Task-Shifting Strategy for HTN control (TASSH) based on the WHO Cardiovascular (CV) Risk Package is an evidence-based strategy for mitigating provider- and systems-level barriers to optimal HTN control. Despite its effectiveness, TASSH remains untested in CHPS zones. Additionally, primary care practices in low- and middle-income countries (LMICs) lack resources and expertise needed to coordinate multilevel system changes without assistance. The proposed study will evaluate the effectiveness of practice facilitation (PF) as a quality improvement strategy for implementing TASSH within CHPS zones in Ghana. Guided by the Consolidated Framework for Implementation Research and the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, we will evaluate, in a hybrid clinical effectiveness-implementation design, the effect of PF on the uptake of an evidence-based TASSH, among 700 adults who present to 70 CHPS zones with uncontrolled HTN. Components of the PF strategy include (a) an advisory board that provides leadership support for implementing the intervention within the CHPS zones and (b) trained task-strengthening facilitators (TSFs) who serve as practice coaches to provide training, and performance feedback to community health officers (CHOs) who will deliver TASSH at the CHPS zones. For this purpose, the TSFs are trained to identify, counsel, and refer adults with uncontrolled HTN to community health centers in Bono East Region of Ghana. Uptake of community-based evidence-supported interventions for hypertension control in Ghana is urgently needed to address the CVD epidemic and its associated morbidity, mortality, and societal costs. Findings from this study will provide policymakers and other stakeholders the “how to do it” empirical literature on the uptake of evidence-based task-strengthening interventions for HTN control in Ghana and will serve as a model for similar action in other low, middle-income countries. ClinicalTrials.gov, NCT03490695. Registered on 6 April 2018. Version 1, date: 21 August, 2019.
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影响因子：
12.7
作者：
Glasgow, RE;Vogt, TM;Boles, SM
通讯作者：
Boles, SM
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
2.9
作者：
Manu A;Hill Z;Ten Asbroek AH;Soremekun S;Weobong B;Gyan T;Tawiah-Agyemang C;Danso S;Amenga-Etego S;Owusu-Agyei S;Kirkwood BR
通讯作者：
Kirkwood BR
影响因子：
7.2
作者：
Aarons, Gregory A.;Glisson, Charles;Landsverk, John A.
通讯作者：
Landsverk, John A.
影响因子：
2.8
作者：
Gyamfi, Joyce;Plange-Rhule, Jacob;Ogedegbe, Gbenga
通讯作者：
Ogedegbe, Gbenga