ANDES trial and integration of the HEARTS model in Puno, Peru.
Background. HEARTS is the regional strategy led by the Pan American Health Organization to strengthen hypertension and diabetes control in primary health care. This report summarizes formative and process evidence from the ANDES trial in Puno, Peru, and its alignment with HEARTS implementation. Meth...
| Publicado en: | Pan American Journal of Public Health Vol. 49; pp. 1 - 11 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
World Health Organization
2025
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=194015670&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 194015670 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 10204989 55OA jtl: Pan American Journal of Public Health issn: 10204989 maglogo: N pubinfo: dt: 2025 vid: 49 pid: 437 pub: World Health Organization artinfo: ui: 194015670 10.26633/RPSP.2025.120 ppf: 1 ppct: 10 formats: tig: atl: ANDES trial and integration of the HEARTS model in Puno, Peru. aug: au: Cuentas-Canal, Gonzalo M. Cordova-Ascona, Lucy de las Fuentes, Lisa Soriano-Moreno, Anderson N. Underhill, Lindsay J. Williams, Kendra N. Vela-Clavo, Zoila Diaz-Arocutipa, Carlos Mendoza, Juan Carlos Geng, Elvin H. Checkley, William Hartinger-Pena, Stella M. Davila-Roman, Victor G. affil: EsSalud Hospital Base III, Puno, Peru Universidad Peruana Cayetano Heredia, Lima, Peru Washington University in St. Louis, Missouri, United States of America Johns Hopkins University, Baltimore, Maryland, United States of America Ministry of Health, Lima, Peru Dirección Regional de Salud, Puno, Peru su: Peru Pan American Health Organization Primary health care Hypertension Treatment of diabetes Community health workers Research protocols Public health infrastructure sug: subj: Primary health care Hypertension Treatment of diabetes Peru Pan American Health Organization Community health workers Research protocols Public health infrastructure keyword: cardiovascular diseases community health workers diabetes mellitus health systems implementation science primary health care agentes comunitarios de salud atención primaria de salud ciencia de la implementación enfermedades cardiovasculares Hipertensión Perú. sistemas de salud agentes comunitários de saúde atenção primária à saúde ciência da implementação doenças cardiovasculares Hipertensão sistemas de saúde cardiovascular diseases community health workers diabetes mellitus health systems implementation science primary health care agentes comunitarios de salud atención primaria de salud ciencia de la implementación enfermedades cardiovasculares Hipertensión Perú. sistemas de salud agentes comunitários de saúde atenção primária à saúde ciência da implementação doenças cardiovasculares Hipertensão sistemas de saúde ab: Background. HEARTS is the regional strategy led by the Pan American Health Organization to strengthen hypertension and diabetes control in primary health care. This report summarizes formative and process evidence from the ANDES trial in Puno, Peru, and its alignment with HEARTS implementation. Methods. We assessed 414 health facilities using an adapted World Health Organization Service Availability and Readiness Assessment (SARA-NCD), conducted 55 semi-structured interviews with health professionals, and applied the Hill-Bone adherence scale to 204 hypertensive patients. Results. Facility readiness was 28% for hypertension and 29% for diabetes. Lower-level facilities -- posts and basic health centers -- showed markedly lower readiness (OR = 0.20 for hypertension; OR = 0.03 for diabetes). Provider interviews identified limited prioritization of hypertension, weak supply chains, and insufficient training. Mean adherence score was 48.3 ± 4.0 (medication 31.6 ± 3.5; appointment-keeping 5.98 ± 1.27; salt reduction 10.67 ± 1.18). Conclusions. Findings reveal major readiness gaps and systemic barriers to hypertension and diabetes management in high-altitude Andean regions. Community health worker-supported interventions such as ANDES can facilitate adoption of HEARTS strategies in resource-limited primary care settings. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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