Clinical trial NCT06379750: Using Healthcare Financing and Digital Technology to Improve Hypertension Prevention and Control in Tanzania
Official title: STOP NCDs: Scaling Up Evidence-based Health System Interventions Through the Use of Sustainable Healthcare Financing and Digital TechnOlogy Platforms to Improve Non- Communicable Disease Prevention and Control in Tanzania
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Hypertension
Diabetes
Keywords: hypertension
diabetes
NCD management
NCD prevention
mHealth
healthcare financing
Lead sponsor: Queen's University
Sponsor class: OTHER
Collaborators: name: Kilimanjaro Clinical Research Institute
name: Muhimbili University of Health and Allied Sciences
First posted: 2024-04-23
Enrollment: 1320
Sex: ALL
Minimum age (years): 21
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Primary purpose: OTHER

Brief summary: The aim of our proposed program is to develop and implement a multilevel, multicomponent and health-financing intervention that will facilitate the scale up of evidence-based strategies to improve non-communicable diseases prevention, detection and control in Tanzania. The investigators will accomplish this by: 1) adapting two intervention components that are candidates for inclusion in a highly effective optimized strategy (called STOP-NCDs) and; (b) Assess their individual and combined effectiveness and 2) conducting a robust, mixed-methods evaluation of the implementation process and assess factors that may influence implementation and sustainability for delivering and scaling the optimized STOP-NCDs strategy. The investigators will select and/or adapt intervention components making up the optimized STOP-NCDs strategy. Using a hybrid clinical-effectiveness implementation design, the investigators will conduct a study in 2 sequential phases: 1) A clinical-effectiveness phase in which the investigators evaluate the effect of our combined strategies (task-sharing and WelTel) versus Usual Care, on rates of systolic BP reduction at 12 months; as well as other secondary outcomes including diagnosis and treatment of diabetes and, patient knowledge of CVD risks and prevention, and, other features of health provider NCD prevention activities. 2) A post-implementation phase in which the investigators use the RE-AIM framework to evaluate changes in the adoption and maintenance of our combined strategies in participating iCHF health facilities across Kilimanjaro region. The investigators will use the WelTel communication and Patient Management platform for to deliver culturally and contextually appropriate evidence-based text messaging to patients. It allows for quality improvement and is a unique tool for our program to scaling low-cost interventions that provide capabilities for tracking of health system service uptake, quality-metrics at health facilities, drug stock-out management, and patient-centered behavioral health interventions. Deployment of WelTel will allow for integration of NCD prevention targeted health services to all adult iCHF members across differing life stages and NCD risk and have a significant impact on increasing quality of care and sustainability of health financing and performance-based incentives through improved prescribing, patient engagement, medication adherence and healthy behaviour change.


Eligibility criteria: Inclusion Criteria:

* All adults with uncontrolled HTN who receive care through iCHF membership and are able to provide informed consent.

Exclusion Criteria:

* Adults with controlled HTN or those without a diagnosis of HTN
* Unable or unwilling to provide informed consent

Primary outcomes:
measure: Systolic blood pressure
timeFrame: 12 months
Secondary outcomes:
measure: Blood pressure control
timeFrame: 12 months
Other outcomes:
Locations:
Study officials:
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