Sustaining an Evidence-based Task-shifting Strategy for Blood Pressure Control in Ghana

加纳维持基于证据的血压控制任务转移策略

基本信息

批准号：
8952757
负责人：
Juliet Iwelunmor
金额：
$ 7.93万
依托单位：
UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2017-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8952757
关键词：
Acute Address Adoption Adult Africa South of the Sahara Area Australia Canada Caring Cluster randomized trial Communicable Diseases Community Health Centers Community Health Nurse Specialist Community Health Nursing Country Data Development District Hospitals Environment Epidemic Evidence based practice Ghana Goals Health Health Personnel Health Professional Health Services Health system Healthcare Systems Hypertension Individual Intervention Lead Life Maintenance Maps Methods Modeling Nurses Outcome Study Participant Patients Perception Phase Physicians Population Positioning Attribute Preparation Primary Health Care Process Research Design Resources Socioeconomic Factors Structure System Testing Time Training United Kingdom United States Work World Health Organization base blood pressure reduction blood pressure regulation cost cost effective design dissemination research evidence base hypertension prevention implementation research implementation science implementation trial innovation public health relevance

项目摘要

DESCRIPTION (provided by applicant): Ghana has a population of 23.5 million people, of which 3.5 million adults are hypertensive. Furthermore, the country's physician-to-population ratio is 1:13,000 nationally. Given such limited resources, cost-effective systems-level strategies are urgently needed to mitigate the rising epidemic of hypertension in countries like Ghana. One such approach is task- shifting, defined as the rational distribution of primary care duties from physicians to non-physician healthcare providers. A cluster-randomized trial of task-shifting and blood pressure control in community health centers (CHCs), district hospitals and with community health nurses (CHN) is currently on-going in Ghana. While the proposed intervention will tell us whether implementation of the task-shifting strategy results in blood pressure reduction and maintenance at the individual level, at present, very little is known about stakeholder perceptions of the intervention itself, or the factors and/or context likely to facilitte or limit sustainment of the strategy beyond the implementation period. One method than can address this is group concept-mapping (GCM), a structured mixed-methods approach that considers the perspectives of different stakeholder groups to identify potential barriers and facilitators likely to impact implementation of EBPs in real- world settings [6]. The goal of this study is to use group concept mapping to identify stakeholder (e.g. CHNs, physicians, etc.) perspectives on the barriers and facilitators likely to influence the sustainment of the task-shifting strategy in Ghana. The specific aims are: 1) To identify stakeholder perspectives on the value of and factors likely to facilitate or hinder the sustainment of the WHO PEN model in Ghana; 2) To assess the perceived importance and likelihood that these factors would be sustained over time; and 3) To develop a conceptual framework on sustaining the WHO PEN model in Ghana. This study will contribute to our knowledge base on the multiple factors that influence sustainment of an evidence based practice in a low-resource setting traditionally underrepresented in dissemination and implementation research.

描述（由申请人提供）：加纳有 2350 万人口，其中 350 万成年人患有高血压。此外，鉴于资源有限，该国的医生与人口的比例为 1:13,000。关卡策略迫切需要减轻加纳等国家日益严重的高血压流行病，其中一种方法是任务转移，即将初级保健职责从医生合理分配给非医生医疗保健提供者。加纳目前正在社区卫生中心 (CHC)、地区医院和社区卫生护士 (CHN) 进行血压控制，而拟议的干预措施将告诉我们任务转移策略的实施是否会导致血压降低。以及个人层面的维护，目前，我们对利益相关者对干预措施本身的看法知之甚少，或者对可能促进或限制实施期后战略维持的因素和/或背景知之甚少。可以解决此问题的一种方法是群体概念图（GCM）。，一种结构化的混合方法，考虑不同利益相关者群体的观点，以确定可能影响现实世界环境中 EBP 实施的潜在障碍和促进因素 [6]。（例如 CHN、医生等）对可能影响加纳任务转移战略维持的障碍和促进因素的看法具体目标是： 1) 确定利益相关者对可能促进或促进任务转移战略的价值和因素的看法。阻碍 WHO PEN 模式在加纳的维持； 2) 评估这些因素随着时间的推移持续存在的重要性和可能性；以及 3) 制定一个在加纳维持 WHO PEN 模式的概念框架。我们的知识库涉及影响在资源匮乏环境中维持循证实践的多种因素，传统上在传播和实施研究中代表性不足。