An implementation science study to enhance cardiovascular disease prevention in Mukono and Buikwe districts in Uganda: a stepped-wedge design.

Background: Uganda is experiencing a shift in major causes of death with cases of stroke, heart attack, and heart failure reportedly on the rise. In a study in Mukono and Buikwe in Uganda, more than one in four adults were reportedly hypertensive. Moreover, very few (36.5%) reported to have ever had...

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Publicado en:BMC Health Services Research Vol. 19; no. 1
Autores principales: Musinguzi, Geofrey, Wanyenze, Rhoda K., Ndejjo, Rawlance, Ssinabulya, Isaac, van Marwijk, Harm, Ddumba, Isaac, Bastiaens, Hilde, Nuwaha, Fred
Formato: clinical trial research Journal Article
Publicado: BioMed Central 4/25/2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 4/25/2019
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        atl: An implementation science study to enhance cardiovascular disease prevention in Mukono and Buikwe districts in Uganda: a stepped-wedge design.
      aug:
        au:
          Musinguzi, Geofrey
          Wanyenze, Rhoda K.
          Ndejjo, Rawlance
          Ssinabulya, Isaac
          van Marwijk, Harm
          Ddumba, Isaac
          Bastiaens, Hilde
          Nuwaha, Fred
        affil: Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
      sug:
        subj:
          Cardiovascular Diseases Prevention and Control
          Health Promotion Administration
          Human
          Quality of Life
          Aged
          Health Facilities
          Health Care Delivery Standards
          Adult
          Young Adult
          Uganda
          Blood Pressure Determination Statistics and Numerical Data
          Health and Welfare Planning
          Hypertension Prevention and Control
          Risk Factors
          Blood Pressure Determination Standards
          Female
          Male
          Primary Health Care Standards
          Adolescence
          Middle Age
          Clinical Trials
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Funding Source
          Aged: 65+ years
          Adult: 19-44 years
          Adolescent: 13-18 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Uganda is experiencing a shift in major causes of death with cases of stroke, heart attack, and heart failure reportedly on the rise. In a study in Mukono and Buikwe in Uganda, more than one in four adults were reportedly hypertensive. Moreover, very few (36.5%) reported to have ever had a blood pressure measurement. The rising burden of CVD is compounded by a lack of integrated primary health care for early detection and treatment of people with increased risk. Many people have less access to effective and equitable health care services which respond to their needs. Capacity gaps in human resources, equipment, and drug supply, and laboratory capabilities are evident. Prevention of risk factors for CVD and provision of effective and affordable treatment to those who require it prevent disability and death and improve quality of life. The aim of this study is to improve health profiles for people with intermediate and high risk factors for CVD at the community and health facility levels. The implementation process and effectiveness of interventions will be evaluated.Methods: The overall study is a type 2-hybrid stepped-wedge (SW) design. The design employs mixed methods evaluations with incremental execution and adaptation. Sequential crossover take place from control to intervention until all are exposed. The study will take place in Mukono and Buikwe districts in Uganda, home to more than 1,000,000 people at the community and primary healthcare facility levels. The study evaluation will be guided by; 1) RE-AIM an evaluation framework and 2) the CFIR a determinant framework. The primary outcomes are implementation - acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, coverage, and sustainability.Discussion: The study is envisioned to provide important insight into barriers and facilitators of scaling up CVD prevention in a low income context. This project is registered at the ISRCTN Registry with number ISRCTN15848572. The trial was first registered on 03/01/2019.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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