Shafika Abrahams-Gessel , Thabang Manyaapelo , Nsika Sithole , Siphephelo Dlamini , Nondumiso Mpanza , Samukelisiwe Nxumalo , Thabisile Mjilo , Joanna Orne-Gliemann , Max Bachmann , Nombulelo Magula , Alison Castle , Mark J. Siedner , Thomas Gaziano
{"title":"对南非农村有效实施社区高血压护理项目的潜在障碍和促进因素的形成性评估：IMPACT-BP试验","authors":"Shafika Abrahams-Gessel , Thabang Manyaapelo , Nsika Sithole , Siphephelo Dlamini , Nondumiso Mpanza , Samukelisiwe Nxumalo , Thabisile Mjilo , Joanna Orne-Gliemann , Max Bachmann , Nombulelo Magula , Alison Castle , Mark J. Siedner , Thomas Gaziano","doi":"10.1016/j.ssmhs.2025.100086","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>In rural KwaZulu-Natal Province, South Africa, less than 25 % of persons with hypertension have controlled blood pressure. We conducted a formative evaluation of current clinic-based care to identify barriers and facilitators that could impact effective implementation of a community-based hypertension intervention (IMPACT-BP).</div></div><div><h3>Methods</h3><div>We conducted individual interviews and group discussions with clinic managers, nurses, community health workers (CHWs), community leaders, and patients to identify barriers and facilitators experienced in clinic-based hypertension care, which could affect the acceptability, feasibility, and implementation of the IMPACT-BP intervention. The Conceptual Model of Implementation Research and the Theoretical Framework of Acceptability guided the design of data collection instruments and analysis. Qualitative data collection was performed by trained social science research assistants, recorded, transcribed, translated, and analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Forty-one participants (92 % women) participated in group discussions (n = 32) or individual interviews (n = 9). Barriers to intervention acceptability and feasibility included inadequate levels of staffing, high patient volumes, distrust of CHWs’ work at clinics and in the community, and insufficient training and equipment for CHWs. Facilitators included home delivery of medications by CHWs.</div></div><div><h3>Conclusions</h3><div>Our findings allowed us to identify specific adaptations to the intervention implementation strategy to make the proposed community-based intervention acceptable and feasible in this setting. Adaptations included employing dedicated CHWs and nurses for trial-related activities, developing an expanded CHW training module on hypertension knowledge, teaching CHWs to measure blood pressure and subsequently train patients to do the same, and training CHWs to educate patients about hypertension management.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100086"},"PeriodicalIF":0.0000,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A formative evaluation of potential barriers and facilitators to inform effective implementation of a community-based hypertension care program in rural South Africa: The IMPACT-BP trial\",\"authors\":\"Shafika Abrahams-Gessel , Thabang Manyaapelo , Nsika Sithole , Siphephelo Dlamini , Nondumiso Mpanza , Samukelisiwe Nxumalo , Thabisile Mjilo , Joanna Orne-Gliemann , Max Bachmann , Nombulelo Magula , Alison Castle , Mark J. Siedner , Thomas Gaziano\",\"doi\":\"10.1016/j.ssmhs.2025.100086\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>In rural KwaZulu-Natal Province, South Africa, less than 25 % of persons with hypertension have controlled blood pressure. We conducted a formative evaluation of current clinic-based care to identify barriers and facilitators that could impact effective implementation of a community-based hypertension intervention (IMPACT-BP).</div></div><div><h3>Methods</h3><div>We conducted individual interviews and group discussions with clinic managers, nurses, community health workers (CHWs), community leaders, and patients to identify barriers and facilitators experienced in clinic-based hypertension care, which could affect the acceptability, feasibility, and implementation of the IMPACT-BP intervention. The Conceptual Model of Implementation Research and the Theoretical Framework of Acceptability guided the design of data collection instruments and analysis. Qualitative data collection was performed by trained social science research assistants, recorded, transcribed, translated, and analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Forty-one participants (92 % women) participated in group discussions (n = 32) or individual interviews (n = 9). Barriers to intervention acceptability and feasibility included inadequate levels of staffing, high patient volumes, distrust of CHWs’ work at clinics and in the community, and insufficient training and equipment for CHWs. Facilitators included home delivery of medications by CHWs.</div></div><div><h3>Conclusions</h3><div>Our findings allowed us to identify specific adaptations to the intervention implementation strategy to make the proposed community-based intervention acceptable and feasible in this setting. Adaptations included employing dedicated CHWs and nurses for trial-related activities, developing an expanded CHW training module on hypertension knowledge, teaching CHWs to measure blood pressure and subsequently train patients to do the same, and training CHWs to educate patients about hypertension management.</div></div>\",\"PeriodicalId\":101183,\"journal\":{\"name\":\"SSM - Health Systems\",\"volume\":\"5 \",\"pages\":\"Article 100086\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-05-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"SSM - Health Systems\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2949856225000388\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"SSM - Health Systems","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949856225000388","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
A formative evaluation of potential barriers and facilitators to inform effective implementation of a community-based hypertension care program in rural South Africa: The IMPACT-BP trial
Background
In rural KwaZulu-Natal Province, South Africa, less than 25 % of persons with hypertension have controlled blood pressure. We conducted a formative evaluation of current clinic-based care to identify barriers and facilitators that could impact effective implementation of a community-based hypertension intervention (IMPACT-BP).
Methods
We conducted individual interviews and group discussions with clinic managers, nurses, community health workers (CHWs), community leaders, and patients to identify barriers and facilitators experienced in clinic-based hypertension care, which could affect the acceptability, feasibility, and implementation of the IMPACT-BP intervention. The Conceptual Model of Implementation Research and the Theoretical Framework of Acceptability guided the design of data collection instruments and analysis. Qualitative data collection was performed by trained social science research assistants, recorded, transcribed, translated, and analyzed using thematic analysis.
Results
Forty-one participants (92 % women) participated in group discussions (n = 32) or individual interviews (n = 9). Barriers to intervention acceptability and feasibility included inadequate levels of staffing, high patient volumes, distrust of CHWs’ work at clinics and in the community, and insufficient training and equipment for CHWs. Facilitators included home delivery of medications by CHWs.
Conclusions
Our findings allowed us to identify specific adaptations to the intervention implementation strategy to make the proposed community-based intervention acceptable and feasible in this setting. Adaptations included employing dedicated CHWs and nurses for trial-related activities, developing an expanded CHW training module on hypertension knowledge, teaching CHWs to measure blood pressure and subsequently train patients to do the same, and training CHWs to educate patients about hypertension management.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
