A qualitative evaluation of a simplified cardiovascular management program in Tibet, China.
A qualitative evaluation of a simplified cardiovascular management program in Tibet, China.
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DOI：
10.1186/s12992-018-0342-0
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发表时间：
2018-03-01
影响因子：
10.8
通讯作者：
Yan LL
中科院分区：
文献类型：
--
作者：
Tian M;Yin X;Dunzhu D;Liu Z;Li C;Sun H;Song C;Sangzhu L;Patel A;Redfern J;Yan LL
该干预措施在资源有限的环境中有效地改善了心血管疾病的管理。这项定性研究的目的是检查利益相关者的反馈，并告知未来的研究和扩大规模。共进行了28次面对面的个别访谈。访谈在14个干预村中的6个村由2名讲当地语言的访谈者进行。参与者包括18名心血管疾病高危社区成员、6名乡村医生、2名当地项目协调员和2名县官员。访谈指南用于促进访谈，访谈内容包括干预的感知有用性和内容、干预的保真度和干预的潜在可扩展性。定性访谈采用主题分析编码。参与者的平均年龄为41岁，其中70%是女性。我们的研究结果表明，干预措施是根据方案提供的，并且被高危人群和乡村医生描述为心血管疾病管理的有用方案。然而，高风险人群缺乏知识、医疗保健提供者不足、财政激励不足以及交通和手机信号困难等基础设施不完善，被认为是成功实施和扩大规模的主要障碍。干预措施是按照议定书实施的，并为相关社区成员和卫生专业人员提供了实质性的好处。然而，要在中国农村成功推广，需要解决多个卫生系统障碍。唯一标识符：NCT01503814。2011年12月11日注册。
The simplified cardiovascular management (SimCard Study) program was a cluster randomized controlled trial conducted in Tibet, China to evaluate a multifaceted intervention consisting of appropriate medication prescriptions and lifestyle recommendations delivered by village doctors. The intervention was effective in improving the management of cardiovascular diseases in resource-limited settings. The aim of this qualitative study was to examine stakeholder feedback and to inform future research and scaling up. A total of 28 face-to-face individual interviews were conducted. The interviews were conducted in 6 out of 14 intervention villages by 2 interviewers who speak the local language. Participants included 18 community members at high risk of CVD, 6 village doctors, 2 local project coordinators, and 2 county officials. Interview guides were used to facilitate the interview covering the focus of perceived usefulness and content of the intervention, fidelity to the intervention, and potential scalability of the intervention. Qualitative interviews were coded using thematic analysis. The average age of the participants was 41 years and 70% were female. Our findings showed that the intervention was delivered according to the protocol and was described as a useful program for CVD management by both high-risk individuals and village doctors. However, lack of knowledge among high-risk individuals, insufficient availability of healthcare providers, inadequate financial incentive, and incomplete infrastructure such as difficulty in transportation and cell phone signal were identified as the main barriers to successful implementation and scale-up. The intervention was implemented in line with the protocol and provided substantial benefits for relevant community members and health professionals. However, multiple health system barriers need to be addressed for successful scale-up in rural China. Unique identifier: NCT01503814. Registered 11 December 2011.
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影响因子：
168.9
作者：
Yusuf, S;Hawken, S;Liu, LS
通讯作者：
Liu, LS
影响因子：
37.8
作者：
Wu Y;Benjamin EJ;MacMahon S
通讯作者：
MacMahon S
影响因子：
3.2
作者：
Zhao, Xingshan;Li, Shenshen;Wu, Yangfeng
通讯作者：
Wu, Yangfeng
制定和评估复杂的干预措施：新的医学研究委员会指南。
DOI：
10.1136/bmj.a1655
发表时间：
2008-09-29
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Craig P;Dieppe P;Macintyre S;Michie S;Nazareth I;Petticrew M;Medical Research Council Guidance
通讯作者：
Medical Research Council Guidance
影响因子：
4.5
作者：
Yan LL;Fang W;Delong E;Neal B;Peterson ED;Huang Y;Sun N;Yao C;Li X;MacMahon S;Wu Y
通讯作者：
Wu Y