TY - JOUR
T1 - Dissemination and Implementation Program in Hypertension in Rwanda
T2 - Report on Initial Training and Evaluation
AU - Baumann, Ana A.
AU - Mutabazi, Vincent
AU - Brown, Angela L.
AU - Hooley, Cole
AU - Reeds, Dominic
AU - Ingabire, Cecile
AU - Ndahindwa, Vedaste
AU - Nishimwe, Aurore
AU - Cade, W. Todd
AU - de las Fuentes, Lisa
AU - Proctor, Enola K.
AU - Karengera, Stephen
AU - Schecthman, Kenneth B.
AU - Goss, Charles W.
AU - Yarasheski, Kevin
AU - Newsome, Brad
AU - Mutimura, Eugene
AU - Davila-Roman, Victor G.
N1 - Funding Information:
Supported in part by National Heart, Lung, and Blood Institute grant #U24HL136790.
Funding Information:
Dissemination and implementation (D & I) science, with its multilevel frameworks, outcomes, and designs, is geared toward increasing uptake and sustainment of evidence-based interventions (EBIs) for prevention, treatment, and control of hypertension [10-12] . Suboptimal infrastructure and capacity in Rwanda hinders research and community knowledge for HTN control. Our U24 grant project funded by the National Heart, Lung, and Blood Institute (NHLBI) aims to develop late phase (T4) translational research capacity for control of hypertension in Rwanda through D & I research capacity building.
Publisher Copyright:
© 2019
PY - 2019/6
Y1 - 2019/6
N2 - Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide and in low- and middle-income countries, and hypertension (HTN) is a major risk factor for CVD. Although effective evidence-based interventions for control of HTN in high-income countries exist, implementation of these in low- and middle-income countries has been challenging due to limited capacity and infrastructure for late-phase translational research. In Rwanda, the 2015 STEPS NCD (STEPwise Approach to Surveillance of Noncommunicable Diseases) risk survey reported an overall prevalence of HTN of 15% (95% confidence interval [CI]: 13.8 to 16.3) for those ages 15 to 64 years; prevalence increased with increasing age to 39% (95% CI: 35.7 to 43.1) for those ages 55 to 64 years; CVD was the third most common cause of mortality (7%). Suboptimal infrastructure and capacity in Rwanda hinders research and community knowledge for HTN control. Objectives: To address the issue of suboptimal capacity to implement evidence-based interventions in HTN, this project was designed with the following objectives: 1) to develop a regional needs assessment of infrastructure for dissemination and implementation (D & I) strategies for HTN-CVD control; 2) to develop HTN-CVD research capacity through creation of countrywide resources such as core research facilities and training in the fields of HTN-CVD, D & I, and biostatistics; and 3) to engage and train multiple stakeholders in D & I and HTN-CVD evidence-based interventions. Methods: A weeklong training program in HTN-CVD, biostatistics, and D & I was conducted in Rwanda in August 2018, and pre- and post-D & I training competency questionnaires were administered. Results: Questionnaire results show a statistically significant increase in D & I knowledge and skills as a result of training (full scale pre- to post-test scores: 2.12 ± 0.78 vs. 3.94 ± 0.42; p < 0.0001). Conclusions: Using principles of community engagement and train-the-trainer methods, we will continue to adapt guidelines and treatments for HTN-CVD developed in high-income countries to the context of Rwanda with the goal of establishing a sustainable platform to address the burden of disease from HTN-CVD.
AB - Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide and in low- and middle-income countries, and hypertension (HTN) is a major risk factor for CVD. Although effective evidence-based interventions for control of HTN in high-income countries exist, implementation of these in low- and middle-income countries has been challenging due to limited capacity and infrastructure for late-phase translational research. In Rwanda, the 2015 STEPS NCD (STEPwise Approach to Surveillance of Noncommunicable Diseases) risk survey reported an overall prevalence of HTN of 15% (95% confidence interval [CI]: 13.8 to 16.3) for those ages 15 to 64 years; prevalence increased with increasing age to 39% (95% CI: 35.7 to 43.1) for those ages 55 to 64 years; CVD was the third most common cause of mortality (7%). Suboptimal infrastructure and capacity in Rwanda hinders research and community knowledge for HTN control. Objectives: To address the issue of suboptimal capacity to implement evidence-based interventions in HTN, this project was designed with the following objectives: 1) to develop a regional needs assessment of infrastructure for dissemination and implementation (D & I) strategies for HTN-CVD control; 2) to develop HTN-CVD research capacity through creation of countrywide resources such as core research facilities and training in the fields of HTN-CVD, D & I, and biostatistics; and 3) to engage and train multiple stakeholders in D & I and HTN-CVD evidence-based interventions. Methods: A weeklong training program in HTN-CVD, biostatistics, and D & I was conducted in Rwanda in August 2018, and pre- and post-D & I training competency questionnaires were administered. Results: Questionnaire results show a statistically significant increase in D & I knowledge and skills as a result of training (full scale pre- to post-test scores: 2.12 ± 0.78 vs. 3.94 ± 0.42; p < 0.0001). Conclusions: Using principles of community engagement and train-the-trainer methods, we will continue to adapt guidelines and treatments for HTN-CVD developed in high-income countries to the context of Rwanda with the goal of establishing a sustainable platform to address the burden of disease from HTN-CVD.
UR - http://www.scopus.com/inward/record.url?scp=85068957418&partnerID=8YFLogxK
U2 - 10.1016/j.gheart.2019.06.001
DO - 10.1016/j.gheart.2019.06.001
M3 - Article
C2 - 31324367
AN - SCOPUS:85068957418
SN - 2211-8160
VL - 14
SP - 135
EP - 141
JO - Global Heart
JF - Global Heart
IS - 2
ER -