Acceptability and feasibility of a multicomponent intervention to improve acute myocardial infarction care in Northern Tanzania: The MIMIC pilot trial.
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2025-01
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Abstract
Background
The Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC) was developed to increase the uptake of evidence-based care for acute myocardial infarction in Tanzania. MIMIC consists of five components: triage cards, pocket cards, an online training module, patient educational pamphlets, and clinical champions. Our aim was to determine the acceptability and feasibility of this intervention among emergency department (ED) providers in Tanzania.Methods
During a one-year pilot of the MIMIC intervention at the Kilimanjaro Christian Medical Centre in northern Tanzania, ED physicians and nurses were approached and invited to complete a survey eliciting their perspectives on MIMIC. The survey included the four-item Acceptability of Intervention Measurement (AIM) and four-item Feasibility of Intervention Measurement (FIM) tools. Mean AIM and FIM scores were generated by assigning scores of 1-5 for each response (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree), and dividing by four.Results
Sixty-four participants were enrolled, including 27 (42%) physicians and 37 (58%) nurses. The mean AIM score was 4.82 (sd = 0.31) out of a maximum possible score of 5. The mean FIM score was 4.61 (sd 0.47). Of participants, 63 (98%) reported using the pocket cards and 54 (84%) reported completing the training module, which took a mean of 16.5 (sd 13.3) minutes to complete. Of 36 nurses who worked in triage, all (100%) reported using the MIMIC triage cards.Conclusion
The MIMIC intervention is highly acceptable and feasible in a northern Tanzanian ED. Use of a co-design approach in the development of the MIMIC intervention likely increased the acceptability and feasibility of the intervention among staff. Additional study is needed to determine the effectiveness of this intervention on clinical care processes and patient outcomes.Type
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Hertz, Julian T, Francis M Sakita, Kelvin F Haukila, Pankrasi S Shayo, Frida M Shayo, Joyce Willy, Godfrey Lameck, Emmanuel Kisanga, et al. (2025). Acceptability and feasibility of a multicomponent intervention to improve acute myocardial infarction care in Northern Tanzania: The MIMIC pilot trial. PloS one, 20(9). p. e0333271. 10.1371/journal.pone.0333271 Retrieved from https://hdl.handle.net/10161/33988.
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Julian T Hertz
Julian Hertz, MD, MSc, is an Associate Professor of Emergency Medicine & Global Health. He graduated summa cum laude from Princeton University and attended medical school at Duke University, where he received the Dean's Merit Scholarship and the Thomas Jefferson Award for leadership. He completed his residency training in emergency medicine at Vanderbilt University Medical Center and his fellowship in Global Health at Duke.
Dr. Hertz's primary interests include global health, implementation science, and undergraduate and graduate medical education. Dr. Hertz's research focuses on using implementation science methods to improve cardiovascular care both locally and globally. His current projects involve developing interventions to improve acute myocardial infarction care in Tanzania, to improve management of hypertension among Tanzanians with HIV, and to improve post-hospital care among patients with multimorbidity in East Africa.
Dr. Hertz has received numerous awards for clinical, educational, and research excellence, including the Duke Emergency Medicine Faculty Teacher of the Year Award, the Duke Emergency Medicine Faculty Clinician of the Year Award, and the Duke Emergency Medicine Faculty Researcher of the Year Award. He has also received the Golden Apple Teaching Award from the Duke medical student body, the Duke Master Clinician/Teacher Award, and the Global Academic Achievement Award from the Society of Academic Emergency Medicine.
Hayden Barry Bosworth
Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities.
Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.
Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy
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