Testing a Registry-Based Strategy (ACT+) to Reduce Loss to Follow-Up in Rheumatic Heart Disease Screening in Uganda (SHIELD 2)
Developing and Testing a Registry-Enabled Strategy (ACT+) to Reduce Loss to Follow-Up Between Screening and Confirmation of Rheumatic Heart Disease in Uganda
研究概览
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名：Isabella Brigham
- 电话号码：513-517-1307
- 邮箱：isabella.aspromonte@cchmc.org
学习地点
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Kampala、乌干达
- Uganda Heart Institute
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接触：
- Jafes Pulle
- 电话号码：0784936334
- 邮箱：jpulle@rrcuganda.org
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首席研究员：
- Jafes Pulles
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参与标准
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
描述
Inclusion Criteria: Community Members
- 18 years of age or older
- Received a positive ADUNU echocardiographic screening result within the past 24 months OR parent/legal guardian of a minor who received a positive ADUNU echocardiographic screening result within the past 24 months
Inclusion Criteria: Providers
- Employed at an ADUNU-participating facility or confirmatory echo facilities at the time of study
- Holds a designated ADUNU role (nurse screener, confirmatory provider, or referral support staff) or is involved in RHD screening, diagnosis or care
- Ability to provide informed consent in Acholi, Luo, or English
Inclusion Criteria: Regional RHT ACT Nurse Coordinator
- Employed as a Regional ACT Nurse at the time of study
- Has familiarity with ADUNU program
- Ability to provide informed consent in Acholi, Luo, or English
Inclusion Criteria: District Health Office Team Members and District RHD Focal Persons
- Employed at District Health Office within an ADUNU-participating district
- Has familiarity with ADUNU program
- Ability to provide informed consent in Acholi, Luo, or English
Exclusion Criteria:
- No formal exclusion criteria beyond inability to provide informed consent. Individuals with significant cognitive or communication impairment precluding interview participation will not be enrolled.
学习计划
研究是如何设计的？
设计细节
- 主要用途：放映
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
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无干预：Inspiration/Discovery (1A)
Semi-structured qualitative interviews with screen-positive community members (or parents/guardians of community members) and ADUNU providers to characterize multilevel barriers and facilitators.
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无干预：Ideation/Design (1B)
A structured participatory design workshop with a 15-member HCD expert panel, followed by iterative co-design sessions to produce finalized ACT+ features and workflows.
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有源比较器：Healthcare Facilities will receive ACT+ Intervention
The ACT+ strategy consists of three coordinated, registry-enabled implementation components co-designed and refined through the Aim 1 HCD process. Component 1: Digitized Pre-Confirmation Registry Entry and Patient Tracking ACT+ will enable entry of screen-positive individuals into the ACT registry at the time of positive screen (prior to confirmatory diagnosis). Component 2: Patient Tracing and Reminder System ACT+ will support automated and semi-automated outreach to screen-positive who have not yet completed confirmatory echocardiography. Component 3: Audit and Feedback for Providers and Facilities ACT+ dashboards will provide facility-level, real-time feedback on LTFU rates, confirmation completion, and the screening-to-SAP initiation cascade. |
The Active Community Case Management Tool (ACT) is a cloud-based, dynamic RHD case management tool developed by CCHMC in partnership with global stakeholders, including UHI and the RRCU.
ACT provides real-time data on patient status, clinical outcomes, and care processes, supporting both individual patient management (electronic medical record functions) and system-level quality improvement (registry and dashboard functions).
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无干预：Control: Standard of Care
Facilities in the control arm will continue current standard ADUNU practice: screen-positive individuals receive verbal and written referral information to one of three confirmatory sites immediately following screening.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Facility-level linkage to confirmation rate
大体时间：9 months
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The proportion of individuals with a positive ADUNU screening result who complete confirmatory echocardiography within the 9-month intervention period.
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9 months
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Time (days) from positive screen to confirmatory echocardiography
大体时间：9 months
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% providers entering >90% of screening records OR completing all monthly outreach activities
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9 months
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合作者和调查者
调查人员
- 首席研究员：Andrea Beaton、Children's Hospital Medical Center, Cincinnati
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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