A Study to Evaluate the Best Ways to Implement a Community Health Worker-supported Telehealth Program for Managing High Blood Pressure in Kenya (COMPASS)
Community-based Implementation of Hypertension Screening and Telehealth Systems in Kenya
This study will compare two strategies involving community health workers and telehealth to help control high blood pressure among rural residents in Kenya: basic steps including training, developing protocols, and engaging leaders for supervision, compared to these steps plus additional support from healthcare worker champions and support from an outside facilitator. The program will be tested in 16 health centers and their surrounding catchment areas in Kenya to determine which approach works best.
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
The study's goal is to examine the implementation and effectiveness of two strategies for integrating a community health worker (CHW)-facilitated hypertension telehealth intervention into routine care at primary health centers operated by Kenya's Ministry of Health (MoH). Investigators will conduct a type 2 hybrid implementation-effectiveness cluster randomized trial across 16 MoH primary health centers and surrounding communities in Homa Bay County to compare the impact of core and enhanced strategies on uptake of CHW telehealth and population-level hypertension control at 18 months. A waiver of consent will be obtained for the collection of data for the primary outcomes. CHWs, clinicians, implementation champions, practice facilitators, clinic directors, CHW supervisors and MOH leadership will take part in the implementation, in-depth interviews and surveys.
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Douglas Black
- Telefoonnummer: 415-806-3016
- E-mail: douglas.black@ucsf.edu
Studie Locaties
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Mbita, Kenia
- GPRT
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Contact:
- Janice Litunya, MBChB
- Telefoonnummer: +254-710-710593
- E-mail: litunyajaniceo@gmail.com
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Patient-Level Inclusion Criteria for Primary Outcome Ascertainment (waiver of consent)
- Adults ≥40 years of age
- Residing within the "Community Unit" served by one of the 16 MoH primary care clinics included in the study
- Hypertension diagnosis (BP ≥140/90 mmHg on average of 2nd and 3rd measures on two separate occasions OR ≥160/100 mmHg on average of 2nd and 3rd measures on a single occasion OR currently on antihypertensive therapy)
Exclusion Criteria:
- None
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Onderzoek naar gezondheidsdiensten
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Actieve vergelijker: Core Strategies
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CHWs and clinicians receive case-based training, MoH leadership supervision, implementation blueprints with medication supply strengthening at participating health facilities |
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Experimenteel: Enhanced Strategies
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Core Strategies components plus CHW and clinician champions coaching and motivation with support from practice facilitators |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Implementation: Penetration
Tijdsspanne: Months 0-18
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Proportion of adults 40 years and older with hypertension who receive at least 1 telehealth hypertension visit |
Months 0-18
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Effectiveness: Population-level hypertension control
Tijdsspanne: Months 12-18
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Proportion of adults 40 years and older with hypertension who have controlled blood pressure (<140/90 mmHg) at last measure during months 12-18 |
Months 12-18
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Medewerkers en onderzoekers
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Matt Hickey, MD, University of California, San Francisco
- Hoofdonderzoeker: James Ayieko, MBChB, PhD, MPH, Kenya Medical Research Institute
Publicaties en nuttige links
Algemene publicaties
- Hickey MD, Owaraganise A, Ogachi S, Sunday H, Aoko C, Sang N, Agengo G, Kabami J, Kakande E, Mugoma EW, Schwab J, Sutter N, Black D, Muiru A, Chamie G, Petersen ML, Balzer LB, Bukusi EA, Havlir DV, Kamya MR, Ayieko J. A prospective cohort study of the SEARCH integrated HIV/hypertension community health worker-led intervention in rural Kenya and Uganda. J Int AIDS Soc. 2025 Jul;28 Suppl 3(Suppl 3):e26500. doi: 10.1002/jia2.26500.
- Hickey MD, Ayieko J, Kabami J, Owaraganise A, Kakande E, Ogachi S, Aoko CI, Wafula EM, Sang N, Sunday H, Revill P, Bansi-Matharu L, Shade SB, Chamie G, Balzer LB, Petersen ML, Havlir DV, Kamya MR, Phillips AN. Cost-effectiveness of leveraging existing HIV primary health systems and community health workers for hypertension screening and treatment in Africa: An individual-based modeling study. PLoS Med. 2025 Jan 24;22(1):e1004531. doi: 10.1371/journal.pmed.1004531. eCollection 2025 Jan.
- Hickey MD, Owaraganise A, Ogachi S, Sang N, Wafula EM, Kabami J, Sutter N, Temple J, Muiru A, Chamie G, Kakande E, Petersen ML, Balzer LB, Havlir DV, Kamya MR, Ayieko J. Community health worker-facilitated telehealth for moderate-severe hypertension care in Kenya and Uganda: A randomized controlled trial. PLoS Med. 2025 Jun 5;22(6):e1004632. doi: 10.1371/journal.pmed.1004632. eCollection 2025 Jun.
- Hickey MD, Ayieko J, Owaraganise A, Sim N, Balzer LB, Kabami J, Atukunda M, Opel FJ, Wafula E, Nyabuti M, Brown L, Chamie G, Jain V, Peng J, Kwarisiima D, Camlin CS, Charlebois ED, Cohen CR, Bukusi EA, Kamya MR, Petersen ML, Havlir DV. Effect of a patient-centered hypertension delivery strategy on all-cause mortality: Secondary analysis of SEARCH, a community-randomized trial in rural Kenya and Uganda. PLoS Med. 2021 Sep 20;18(9):e1003803. doi: 10.1371/journal.pmed.1003803. eCollection 2021 Sep.
Studie record data
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Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- COMPASS HTN
- R01HL180265 (Subsidie/contract van de Amerikaanse NIH)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
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