Applying systems thinking to identify enablers and challenges to scale-up interventions for hypertension and diabetes in low-income and middle-income countries: protocol for a longitudinal mixed-methods study.
| Autor: | Ramani-Chander A; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia., Joshi R; The George Institute for Global Health, New Delhi, India.; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia., van Olmen J; Department of Family Health and Population Medicine, University of Antwerp, Antwerpen, Belgium., Wouters E; Department of Sociology, Centre for Population, Family & Health, Faculty of Social Sciences, Univesrity of Antwerp, Antwerp, Belgium., Delobelle P; Chronic Diseases Initiative of Africa, University of Cape Town, Cape Town, South Africa.; Department of Public Health, Vrije Universiteit, Brussel, Belgium., Vedanthan R; Department of Population Health, NYU Grossman School of Medicine, New York City, New York, USA., Miranda JJ; CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia., Oldenburg B; Department of Cardiovascular Research, Translation and Implementation, Baker Heart and Diabetes Institute and La Trobe University, Melbourne, Victoria, Australia., Sherwood S; Fundación EkoRural and Knowledge, Technology and Innovation, Wageningen University, Wageningen, The Netherlands., Rawal LB; School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney, New South Wales, Australia., Mash RJ; Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa., Irazola VE; Department of Chronic Diseases-CESCAS, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina., Martens M; Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.; Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium., Lazo-Porras M; CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru., Liu H; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia., Agarwal G; Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada., Waqa G; C-POND, Fiji National University, College of Medicine, Nursing and Health Sciences, Suva, Fiji., Marcolino MS; Medical School and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Esandi ME; Epidemiological Research Institute, National Academy of Medicine, Buenos Aires, Argentina., Ribeiro ALP; Internal Medicine Department, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.; Head of Research and Innovation, Hospital das Clínicas, Universidade Federal de Minas Gerais, Minas Gerais, Brazil., Probandari A; Department of Public Health, Faculty of Medicine, Universitas Sebalas Maret, Saurakarta, Indonesia., González-Salazar F; Departamento de Ciencias Básicas, Division de Ciencias de la Salud, Universidad de Monterrey, Monterrey, Mexico., Shrestha A; Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.; Dhulikhel Hospital, Dhulikhel, Nepal., Sujarwoto S; Department of Public Administration, University of Brawijaya, Malang, Indonesia., Levitt N; Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa., Paredes M; Facultad Latinoamericana de Ciencias Sociales Sede Ecuador (FLACSO), Quito, Ecuador., Sugishita T; Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, Tokyo, Japan., Batal M; Nutrition Department, Faculty of Medicine, University of Montreal, Montreal, Québec, Canada.; Centre for Public Health Research (CReSP), Montreal, Québec, Canada., Li Y; Nutrition and Lifestyle Program, The George Institute for Global Health at Peking University Health Science Centre, Beijing, China.; Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia., Haghparast-Bidgoli H; Institute for Global Health, University College London, London, UK., Naanyu V; Moi University and AMPATH Research, Eldoret, Kenya., He FJ; Wolfson Institute of Population Health, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Sqaure, London, UK., Zhang P; Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.; The George Institute for Global Heath at Peking University Health Science Center, Beijing, China., Mfinanga SG; Muhimbili Centre, National Institute for Medical Research, Dar es Salaam, Tanzania.; Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK., De Neve JW; Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany., Daivadanam M; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.; Department of Global Public Health, Karolinska Instituet, Solna, Sweden., Siddiqi K; Department of Health Sciences, University of York, York, UK., Geldsetzer P; Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, California, USA.; Chan Zuckerberg Biohub, San Franciso, Caliornia, USA., Klipstein-Grobusch K; Julius Global Health, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.; Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Huffman MD; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.; Cardiovascular Division and Global Health Center, Washington University in St. Louis, St. Louis, Missouri, USA., Webster J; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia., Ojji D; Department of Internal Medicine, Faculty of Clinical Sciences, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria., Beratarrechea A; Department of Research in Chronic Diseases, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina., Tian M; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.; School of Public Health, Harbin Medical University, Harbin, China., Postma M; Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center, Groningen, The Netherlands., Owolabi MO; Department of Medicine, University of Ibadan, Ibadan, Nigeria., Birungi J; Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine (MRC/UVRI& LSHTM), Entebbe, Uganda.; The AIDS Support Organisation (TASO), Entebbe, Uganda., Antonietti L; Health Sciences Institute, Universidad Nacional Arturo Jauretche, Florencio Varela, Buenos Aires, Argentina., Ortiz Z; Epidemiological Research Institute, National Academy of Medicine, Buenos Aires, Argentina., Patel A; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia., Peiris D; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia., Schouw D; Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa., Koot J; Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center, Groningen, The Netherlands., Nakamura K; Department of Global Health Entrepreneurship, Division of Public Health,Tokyo Medical and Dental University, Tokyo, Japan., Tampubolon G; Global Development Institute, University of Manchester, Manchester, UK., Thrift AG; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia amanda.thrift@monash.edu. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ open [BMJ Open] 2022 Apr 18; Vol. 12 (4), pp. e053122. Date of Electronic Publication: 2022 Apr 18. |
| DOI: | 10.1136/bmjopen-2021-053122 |
| Abstrakt: | Introduction: There is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to 27 collaborative projects, which were funded by the Global Alliance for Chronic Diseases (GACD) 2019 Scale Up Call, reflecting a total funding investment of approximately US$50 million. These projects represent diverse countries, contexts and adopt varied approaches and study designs to scale-up complex, evidence-based interventions to improve hypertension and diabetes outcomes. A systematic inquiry of these projects will provide necessary scientific insights into the enablers and challenges in the scale up of complex NCD interventions. Methods and Analysis: We will apply systems thinking (a holistic approach to analyse the inter-relationship between constituent parts of scaleup interventions and the context in which the interventions are implemented) and adopt a longitudinal mixed-methods study design to explore the planning and early implementation phases of scale up projects. Data will be gathered at three time periods, namely, at planning (T Ethics and Dissemination: The current protocol was approved by the Monash University Human Research Ethics Committee (HREC number 23482). Informed consent will be obtained from all participants. The study findings will be disseminated through peer-reviewed publications and more broadly through the GACD network. Competing Interests: Competing interests: JvO reports Horizon2020 grants (643 692 and 825432) outside the submitted work. AGT declares funding from the National Health & Medical Research Council (NHMRC, Australia: GNT1042600, GNT1122455, GNT1171966, GNT1143155, GNT1182017), Stroke Foundation Australia (SG1807), and Heart Foundation Australia (VG102282) outside the submitted work. ML-P declares support from Fogarty International Centre, National Institutes of Health [R21TW009982], under the Global Alliance for Chronic Diseases (GACD) Diabetes ProgramProgramme. MEE reports grant funding from the Argentinian Ministry of Health (MoH) under the GACD program. AS declares funding from the Japan Agency for Medical Research & Development, as part of the GACD, outside the submitted work. FJH is partially funded by the National Institute for Health Research (NIHR) and the Medical Research Council (MRC), and is a member of the Action on Salt, and World Action on Salt, Sugar and Health (WASSH). AB declares grants from the MoH Argentina, National Institutes of Health, and World Diabetes Foundation, outside the submitted work. AP declares grant and fellowship support from the NHMRC outside the submitted work, Member of the Board of Directors, The George Institute India, and past Member of the Board of Directors, Heart Health Research Center, Beijing, PRC. RJ declares grant, outside the submitted work, from WHO Geneva, WHO South-East Asia Region (SEARO), Elrha Research for Health in Humanitarian Crises (R2HC), (Wellcome Trust, UK AID and NHS), DBT/ Wellcome Trust India Alliance and Gates Foundation. In the past 3 years, MDH has received research funding from American Heart Association, Verily, and AstraZeneca for research unrelated to this manuscript and has patents pending for heart failure polypills. The George Institute for Global Health has a patent, license, and has received investment funding with intent to commercialize fixed-dose combination therapy through its social enterprise business, George Medicines. None of the others authors has any conflict of interest to declare. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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