Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial.

Vedanthan, Rajesh

Kamano, Jemima H

Naanyu, Violet

Delong, Allison K

Were, Martin C

Finkelstein, Eric A

Menya, Diana

Akwanalo, Constantine O

Bloomfield, Gerald S

Binanay, Cynthia A

Velazquez, Eric J

Hogan, Joseph W

Horowitz, Carol R

Inui, Thomas S

Kimaiyo, Sylvester

Fuster, Valentin

England

2017-07-07T14:05:02Z

2017-07-07T14:05:02Z

2014-04-27

BACKGROUND: Hypertension is the leading global risk factor for mortality. Hypertension treatment and control rates are low worldwide, and delays in seeking care are associated with increased mortality. Thus, a critical component of hypertension management is to optimize linkage and retention to care. METHODS/DESIGN: This study investigates whether community health workers, equipped with a tailored behavioral communication strategy and smartphone technology, can increase linkage and retention of hypertensive individuals to a hypertension care program and significantly reduce blood pressure among them. The study will be conducted in the Kosirai and Turbo Divisions of western Kenya. An initial phase of qualitative inquiry will assess facilitators and barriers of linkage and retention to care using a modified Health Belief Model as a conceptual framework. Subsequently, we will conduct a cluster randomized controlled trial with three arms: 1) usual care (community health workers with the standard level of hypertension care training); 2) community health workers with an additional tailored behavioral communication strategy; and 3) community health workers with a tailored behavioral communication strategy who are also equipped with smartphone technology. The co-primary outcome measures are: 1) linkage to hypertension care, and 2) one-year change in systolic blood pressure among hypertensive individuals. Cost-effectiveness analysis will be conducted in terms of costs per unit decrease in blood pressure and costs per disability-adjusted life year gained. DISCUSSION: This study will provide evidence regarding the effectiveness and cost-effectiveness of strategies to optimize linkage and retention to hypertension care that can be applicable to non-communicable disease management in low- and middle-income countries. TRIAL REGISTRATION: This trial is registered with (NCT01844596) on 30 April 2013.

https://www.ncbi.nlm.nih.gov/pubmed/24767476

1745-6215-15-143

1745-6215

https://hdl.handle.net/10161/15036

eng

Springer Science and Business Media LLC

Trials

10.1186/1745-6215-15-143

African Continental Ancestry Group

Blood Pressure

Cell Phones

Clinical Protocols

Communication

Community Health Services

Community Health Workers

Cost-Benefit Analysis

Health Behavior

Health Care Costs

Health Knowledge, Attitudes, Practice

Humans

Hypertension

Kenya

Motivational Interviewing

Patient Compliance

Patients

Professional-Patient Relations

Research Design

Rural Health Services

Time Factors

Treatment Outcome

Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial.

Journal article

Bloomfield, Gerald S|0000-0002-7176-1611

Velazquez, Eric J|0000-0003-2245-7477

https://www.ncbi.nlm.nih.gov/pubmed/24767476

143

Clinical Science Departments

Duke

Duke Clinical Research Institute

Institutes and Centers

Institutes and Provost's Academic Units

Medicine

Medicine, Cardiology

School of Medicine

Published online

15