Family Medicine Commons^™

Implementation And Evaluation Of Employee Health And Wellness Program Using Re-Aim Framework, Unab I. Khan, Asra Qureshi, Karishma Lal, Shehreen Ali, Arshnoor Barkatalia, Shamim Nayani

Department of Family Medicine

Purpose: To describe the design, implementation, and evaluation of an employer-sponsored health screening program [Employee Health and Wellness Program (EHWP)] in an academic healthcare system in Pakistan.
Design/methodology/approach: One-year after implementation, we use the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) to evaluate and report participant- and organizational-level indicators of success.
Findings: Of 5286 invited employees, 4523 (86%) completed blood work and 1809 (34%) completed health risk assessment (Reach). Of the 915 (51%) who required referrals, 3% were referred for new diagnoses of diabetes, hepatitis C or severe anemia; 63% for elevated 10- year risk of cardiometabolic diseases (cardiovascular …

Use Of Simulation Based Technology In Pre-Clinical Years Improves Confidence And Satisfaction Among Medical Students, Muhammad Bilal Mirza, Anjiya Sulaiman, Satwat Hashmi, Samar Zaki, Rehana Rehman, Rozmeen Akbar

Medical College Documents

Objective: To determine perception of medical students about learning from integrated simulated clinical skill sessions as part of the undergraduate curriculum.
Methods: The cross-sectional study was conducted at the Centre for Innovation in Medical Education, Aga Khan University (AKU), Karachi, from July 2018 to February 2019, and comprised first year medical students undertaking the Respiration and Circulation module of the curriculum. Quantitative data was collected using a questionnaire and the responses were assessed on a five-point Likert scale. Data was analysed using SPSS 21. Qualitative data was gathered through focused group discussion with students and an in-depth interview with the …

Assessment Of Knowledge, Attitude, And Practice Of Child Abuse Amongst Health Care Professionals Working In Tertiary Care Hospitals Of Karachi, Pakistan, Khuld Nihan, Aamir Makda, Huzaifah Salat, Munawar Khursheed, Jabeen Fayyaz, Uzma Rahim Khan

Department of Emergency Medicine

Introduction: UNICEF report (2004) states that a significant percentage of total child population under the age of 5 years suffered malnutrition. Child sexual abuse remains undiscussed across Pakistan. Health care professionals (HCPs) are usually the first notifiers of child abuse and are ethically obliged to manage and report it.
Objective: This study was conducted to assess HCPs' response in dealing with patients of child abuse. With a better understanding, we can have a better outcome for the victims.
Methods: A total of 101 participants filled out a structured questionnaire by HCPs working in three tertiary hospitals of Karachi i.e., Aga …

Telemedicine: A New Frontier In Clinical Practice, Munazza Asad, Nooresahar, Saniya Sabzwari

Department of Family Medicine

The COVID-19 pandemic has highlighted the important role of telemedicine as a tool for safe healthcare delivery across the world. While its use was more common in the developed world, the developing world has also adopted this strategy. It is important to develop a clear process and contextual guidance for effective use of this strategy for better patient-doctor interaction and its role in teaching/learning of trainees.

Elderly Musculoskeletal Disease Burden In Karachi, Pakistan: Associations And Implications For Developing Countries, Saniya Sabzwari, Zafar Fatmi, Adeel Ahmed Khan

Department of Family Medicine

Objective: The global rise in the older population has increased the rates of osteoporosis and osteoarthritis, conditions that impact mobility and functionality. There is limited data on musculoskeletal disease in older populations residing in developing countries.
Methods: A community-based study using multistage cluster random sampling of older individuals was conducted in Karachi. Predefined criteria were used for osteoporosis and osteoarthritis. Gait assessment was performed.
Results: More than half of the participants were females and 53% reported illiteracy. Around 30% had osteoporosis and two-thirds had osteoarthritis. Multivariate analysis showed associations of female sex, Pashtun ethnicity, illiteracy, and hypertension with the combined …

Association Between Duration Of Residence And Prevalence Of Type 2 Diabetes Among Male South Asian Expatriate Workers In The United Arab Emirates: A Cross-Sectional Study, Syed Mahboob Shah, Lindsay M. Jaacks, Fatima Al-Maskari, Juma Al-Kaabi, Faisal Aziz, Elpidoforos Soteriades, Tom Loney, Hamed Farooqi, Anjum Memon, Raghib Ali

Department of Family Medicine

Expatriates account for about 80% of the total population in the United Arab Emirates (UAE). This study aimed to evaluate the hypothesis that prevalence of type 2 diabetes in male South Asian expatriates increases with increased length of residence in the UAE.
Design, settings and participants: This cross-sectional study recruited a representative sample (n=1375) of male South Asian expatriates aged ≥18 years in Al Ain, UAE. Sociodemographic, anthropometric and lifestyle data were obtained using a pilot-tested adapted version of the WHO STEPS instrument.
Main outcome measures: Duration of residence was used as a marker for acculturation. Type 2 diabetes was …

Perceptions, Knowledge And Attitudes Towards The Concept And Approach Of Palliative Care Amongst Caregivers: A Cross-Sectional Survey In Karachi, Pakistan, Sameera Shah, Faizan Qaisar, Iqbal Azam Syed, Khairunnisa Mansoor

Department of Family Medicine

Background: Limited comprehension of the concept of palliative care and misconceptions about it are barriers to meaningful utilisation of palliative care programs. As caregivers play an integral role for patients with terminal illness, it is necessary to assess their perceptions and attitudes towards the palliative care approach.
Method: A cross-sectional survey was conducted. Data was collected from the Aga Khan Hospital in-patient and out-patient departments and home-based palliative care services. All adult caregivers who met the inclusion criteria and consented, completed a questionnaire till the sample size was reached. Univariate and multivariate multivariable analysis was done and results were reported …

Sleep And Its Relation With Academic Performance Among Adolescents: An Analytical Cross Sectional Study In Gulshan Town, Karachi, Zainab Mohammad Anjarwala, Niloufer Sultan Ali, Kashmira Nanji, Anum Arshad Beg, Veena Kumari Karmani

Department of Family Medicine

Objective: To determine the prevalence of sleep patterns and their relationship with academic performance among adolescents.
Methods: The analytical cross-sectional study was conducted from March to August 2015 in Gulshan Town of Karachi and comprised students in grades 6 to 8 who were selected from six government and private schools. Data was collected regarding their sleeping time, wake-up time, sleep latency and total sleep duration. Paediatric Daytime Sleepiness Scale was administered to calculate daytime sleepiness. Academic performance of students was taken from school academic records. Data was analysed using SPSS 22.
Results: Of the 440 subjects, 234 (53.2%) were boys …

Applicants' Interview Experience Of Family Medicine Residency Match: Reflections From A Quality Improvement Initiative At A Community Hospital, Abdul Waheed, Masooma S. Rana, Muhammad A. Rauf, Landen Green, Salma Green, Erum Azhar

Medical College Documents

Background and objective: Both family medicine applicants and programs dedicate significant resources to the interview process, a time for both parties to make an impression on the other in an attempt to find their best match. Despite the importance of this process, little research has been completed to ensure the process efficiently addresses applicant preferences on interview day and the surrounding process. This study aimed to determine the factors influencing the family medicine applicant preferences regarding the pre-interview, interview, and post-interview ranking process.
Methods: The study method was a cross-sectional electronic survey utilizing anonymous questionnaires that assessed demographics, pre-interview, interview, …

Magnitude Of Screening For Gestational Diabetes Mellitus In An Urban Setting In Tanzania; A Cross-Sectional Analytic Study, Akampa Mukuve, Mariam Noorani, Ibrahim Sendagire, Miriam Mgonja

Family Medicine, East Africa

Background: Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During antenatal care (ANC) it is important to detect conditions that complicate pregnancy, like gestational diabetes mellitus (GDM). Despite international and local guidelines recommending screening for GDM during ANC, there is evidence to suggest that the practice was not being carried out adequately. A major challenge may be lack of consensus on uniform GDM screening and diagnostic guidelines internationally and locally.

The primary objective was to determine the magnitude of screening for GDM among …

Magnitude Of Screening For Gestational Diabetes Mellitus In An Urban Setting In Tanzania; A Cross-Sectional Analytic Study, Akampa Mukuve, Mariam Noorani, Ibrahim Sendagire, Miriam Mgonja

Faculty of Health Sciences, East Africa

Background

Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During antenatal care (ANC) it is important to detect conditions that complicate pregnancy, like gestational diabetes mellitus (GDM). Despite international and local guidelines recommending screening for GDM during ANC, there is evidence to suggest that the practice was not being carried out adequately. A major challenge may be lack of consensus on uniform GDM screening and diagnostic guidelines internationally and locally.

The primary objective was to determine the magnitude of screening for GDM among …

Effectiveness Of Home-Based Rehabilitation Program In Minimizing Disability And Secondary Falls After A Hip Fracture: Protocol For A Randomized Controlled Trial, Anum Sadruddin Pidani, Saniya Sabzwari, Khabir Ahmad, Ata Khan, Shahryar Noordin

Department of Surgery

Introduction: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population.
Methods and analysis: …

Cigarette Smoking And Smokeless Tobacco Use Among Male South Asian Migrants In The United Arab Emirates: A Cross-Sectional Study, Raghib Ali, Tom Loney, Mohammed Al-Houqani, Iain Blair, Faisal Aziz, Salma Al Dhaheri, Iffat El Barazi, Elpidoforos S. Soteriades, Syed M. Shah

Department of Family Medicine

Background: Few data were available on smoking and smokeless tobacco use in South Asian migrants in the United Arab Emirates (UAE). This study aimed to identify the prevalence and correlates of cigarette smoking and smokeless tobacco use in male South Asian migrants in the UAE.
Methods: We used a cross-sectional study to recruit a random representative sample of male South Asian migrants, including Indian (n = 433), Pakistani (n = 383) and Bangladeshi (n = 559) nationalities. We used multivariable logistic regression analysis to identify significant correlates of cigarettes smoking and smokeless tobacco use.
Results: 1375 South Asian migrant adult …

Exploring The Experiences Of The Older Adults Who Are Brought To Live In Shelter Homes In Karachi, Pakistan: A Qualitative Study, Laila Akber Cassum, Keith Cash, Waris Qidwai Dr, Samina Vertejee

School of Nursing & Midwifery

Background: The traditional joint family system in a culturally diverse Pakistani society shows great respect and care for older population by the families and their generations. However, in the recent years the phenomenon of population ageing in Pakistan is rapidly increasing due to demographic shift influencing life expectancy, along with changes in socio-cultural values. This transition has resulted in institutionalization of the elderly as an emerging shelter alternative. The aim of this study was to explore the experiences of the elderly people and to identify the reason which compelled them to reside in these shelter homes.
Method: A …

Prevalence Of And Factors Associated With Female Sexual Dysfunction Among Women Using Hormonal And Non-Hormonal Contraception At The Aga Khan University Hospital Nairobi, Momin Butt, Valentino Lema, Abraham Mukaindo, Gulnaz Mohamoud, Jacob Shabani

Family Medicine, East Africa

Background: Female sexual function (FSD) is a complex phenomenon. It integrates all body systems and is influenced by a variety of factors. Contraceptives have shown to have variable effects on FSD. In Kenya, the majority of women use hormonal contraception with high rates of discontinuation of use, attributed to related side effects such as weight loss and loss of libido.

Aim: To determine the prevalence of and the factors affecting FSD among women using contraception in our setting.

Setting: The study was carried out at the Aga Khan University Hospital, Nairobi, at various clinical sites.

Methods: A cross-sectional study was …

Regional Variation In Chronic Kidney Disease And Associated Factors In Hypertensive Individuals In Rural South Asia: Findings From Control Of Blood Pressure And Risk Attenuation-Bangladesh, Pakistan And Sri Lanka, Liang Feng, Hithanadura Asita De Silva, Imtiaz Jehan, Anuradhani Kasturiratne, Gulshan Himani, Mohammad Abul Hasnat, Tazeen Jafar, Cobra-Bps Study Group

Community Health Sciences

Background: We aimed to determine the prevalence of chronic kidney disease (CKD) and its cross-country variation among hypertensive individuals in rural Bangladesh, Pakistan and Sri Lanka. We also explored the factors associated with CKD in these populations.
Method: We studied baseline data from the Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan and Sri Lanka (COBRA-BPS) trial, an ongoing cluster randomized controlled trial on 2643 hypertensive adults ≥40 years of age from 30 randomly selected rural clusters, 10 in each of the three countries. CKD was defined as an estimated glomerular filtration rate (eGFR) /min/1.73 m2 or a urine albumin:creatinine …

Prevalence And Correlates Of Cardiometabolic Multimorbidity Among Hypertensive Individuals: A Cross-Sectional Study In Rural South Asia—Bangladesh, Pakistan And Sri Lanka, Liang Feng, Imtiaz Jehan, H Asita De Silva, Aliya Naheed, Hamida Farazdaq, Samina Hirani Samina Hirani, Anuradhani Kasturiratne, Channa D. Ranasinha, Md Tauhidul Islam, Ali Tanweer Siddiquee, Tazeen Jafar

Community Health Sciences

Objective: To determinate the prevalence and correlates of cardiometabolic multimorbidity (CMM), and their cross-country variation among individuals with hypertension residing in rural communities in South Asia.
Design: A cross-sectional study.
Setting: Rural communities in Bangladesh, Pakistan and Sri Lanka.
Participants: A total of 2288 individuals with hypertension aged ≥40 years from the ongoing Control of Blood Pressure and Risk Attenuation- Bangladesh, Pakistan and Sri Lanka clinical trial.
Main outcome measures: CMM was defined as the presence of ≥2 of the conditions: diabetes, chronic kidney disease, heart disease and stroke. Logistic regression was done to evaluate the correlates of CMM.
Results: …

Factors Associated With Geriatric Morbidity And Impairment In A Megacity Of Pakistan, Saniya Sabzwari, Romaina Iqbal, Zafar Fatmi, Iqbal Azam Syed

Department of Family Medicine

Background: The elderly population is increasing globally. In Pakistan, the elderly comprise 6% of the population that is predicted to triple by 2050. Non-communicable diseases are common health problems of the elderly in Pakistan, however, resulting geriatric impairments and disability are unknown. This study was conducted to determine geriatric impairments and identify associated socio-demographic factors and comorbidities among community dwelling elderly in Karachi, Pakistan.
Methods: A cross-sectional study was conducted during 2013-2014. Community clusters were selected from all sub-districts of Karachi, the largest city of Pakistan. Data was collected from systematically selected households within these clusters from individuals, aged ≥60 …

Medical Students: A Reflective Journey Over Time, Saniya Sabzwari, Kulsoom Ghias, Anjiya Sulaiman

Department of Family Medicine

Experiences in medical education have changed significantly in the last two decades. This evolution is apparent in the teaching/ learning environment, types of education resources and learners. In this article two students provide a reflective account of their individual journeys in medical education spanning across 20 years. While some things remain unchanged, significant differences emerge that stress upon the educators and institutions to stay mindful of these transitions in order to develop learning environments that nurture the growth of future physicians.Experiences in medical education have changed significantly in the last two decades. This evolution is apparent in the teaching/ learning …

Regional Variation In Comorbid Prediabetes And Diabetes And Associated Factors Among Hypertensive Individuals In Rural Bangladesh, Pakistan, And Sri Lanka, Liang Feng, Aliya Naheed, H. Asita De Silva, Imtiaz Jehan, Rubhana Raqib, Md Tauhidul Islam, Nathasha Luke, Anuradhani Kasturiratne, Hamida Farazdaq, Sahar Senan, Tazeen Jafar, Cobra-Bps Study Group

Community Health Sciences

We aimed to explore the cross-country variation in the prevalence of comorbid prediabetes or diabetes and determine the sociodemographic, lifestyle, and clinical factors, especially body mass index (BMI) and waist circumference, associated with comorbid diabetes in individuals with hypertension in rural South Asia. We analyzed cross-sectional data of 2426 hypertensive individuals of ≥40 years from 30 randomly selected rural communities in Bangladesh, Pakistan, and Sri Lanka. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dL without use of antidiabetic treatment and diabetes as FPG ≥126 mg/dL or use of antidiabetic medication. The prevalence (95% CI) of …

Lifestyle, Cardiovascular Risk Knowledge And Patient Counselling Among Selected Sub-Saharan African Family Physicians And Trainees. African Journal Of Primary Health Care & Family Medicine, Pius O. Ameh, Kenneth Yakubu, Miriam Miima, Olugbemi Popoola, Gulnaz Mohamoud, Klaus B. Von Pressentin

Family Medicine, East Africa

Background: Cardiovascular disease (CVD)-related deaths in sub-Saharan Africa (SSA) are on the rise, and primary care physicians could facilitate the reversal of this trend through treatment and prevention strategies.

Aim: The aim of this study was to determine the relationship between physician lifestyle practices, CVD prevention knowledge and patient CVD counselling practices among family physicians (FPs) and family medicine (FM) trainees affiliated to FM colleges and organisations in SSA.

Setting: FPs and FM trainees affiliated to FM colleges and organisations in Anglophone SSA.

Methods: A web-based cross-sectional analytical study was conducted using validated, self-administered questionnaires. Following …

Medical Doctors' Offline Computer-Assisted Digital Education: Systematic Review By The Digital Health Education Collaboration, Hayfaa Abdelmageed Wahabi, Samia Ahmed Esmaeil, Khawater Hassan Bahkali, Maher Abdelraheim Titi, Yasser Sami Amer, Amel Ahmed Fayed, Amr Jamal, Nasriah Zakaria, Amna Rehana Siddiqui, Monika Semwal

Community Health Sciences

Background: The widening gap between innovations in the medical field and the dissemination of such information to doctors may affect the quality of care. Offline computer-based digital education (OCDE) may be a potential solution to overcoming the geographical, financial, and temporal obstacles faced by doctors.
Objective: The objectives of this systematic review were to evaluate the effectiveness of OCDE compared with face-to-face learning, no intervention, or other types of digital learning for improving medical doctors' knowledge, cognitive skills, and patient-related outcomes. Secondary objectives were to assess the cost-effectiveness (CE) of OCDE and any adverse effects.
Methods: We searched major bibliographic …

Enhancing Cognitive Engagement Of Pre-Clinical Undergraduate Medical Students Via Video Cases And Interactive Quizzes In Problem-Based Learning, Syeda Sadia Fatima, Kulsoom Ghias, Kauser Jabeen, Saniya Sabzwari

Department of Biological & Biomedical Sciences

Background: Problem-based learning (PBL) is one of the main pedagogical approaches utilized in the undergraduate medical education (UGME) program at a private medical college in Karachi, Pakistan. Video-enhanced cases and formative assessments were introduced at the end of PBL sessions to evaluate their effectiveness in enhancing student engagement.
Methods: A mixed methods study was conducted with Year 2 medical students (n=102; divided into 11 groups) and faculty (n=11) facilitating the PBL process. Of the 10 PBL cases, five were converted to video-enhanced cases and five were kept as paper-based, “traditional” cases. “Micro” videos were used to introduce clinical scenarios, augmented …

Determinants Of Uncontrolled Hypertension In Rural Communities In South Asia-Bangladesh, Pakistan, And Sri Lanka, Tazeen Jafar, Mihir Gandhi, Imtiaz Jehan, Aliya Naheed, H Asita De Silva, Hunaina Shahab, Dewan Alam, Nathasha Luke, Ching Wee Lim Wee Lim, Cobra-Bps Study Group

Community Health Sciences

Background: Uncontrolled blood pressure (BP) is a leading risk factor for death and disability in South Asia. We aimed to determine the cross-country variation, and the factors associated with uncontrolled BP among adults treated for hypertension in rural South Asia.
Methods: We enrolled 1718 individuals aged ≥40 years treated for hypertension in a cross-sectional study from rural communities in Bangladesh, Pakistan, and Sri Lanka. Multivariable logistic regression model was used to determine the factors associated with uncontrolledBP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg).
Results: Among hypertensive individuals, 58.0% (95% confidence interval 55.7, 60.4) had uncontrolled BP: 52.8% …

Influence Of Supportive Care On Chemotherapy Patients' Self-Care Behaviour And Satisfaction: A Pilot Study Conducted In Karachi, Pakistan, Salima Shams, Adnan Jabbar, Kashmira Nanji, Rafat Jan, Ambreen Tharani

School of Nursing & Midwifery

Background and aim: Cancer is a daunting illness affecting a vast number of people globally. During the illness trajectory, cancer patients suffer from physical and/or psychosocial issues. These physical and psychosocial issues demand conscious actions by patients to maintain their well-being. Hence, the objective of the pilot study was to evaluate the level of self-care behaviors and satisfaction in women suffering from cancer after exposure to supportive care (education and mind diversion activities) delivered via a patient help group program.
Methods: The study was conducted at the chemotherapy day care unit of one of the tertiary care hospitals …

Frequency And Factors Associated With Adult Immunization In Patients Visiting Family Medicine Clinics At A Tertiary Care Hospital, Karachi, Samar Zaki, Asma Usman, Swaleha Tariq, Sameena Shah, Iqbal Azam Syed, Waris Qidwai, Kashmira Nanji

Department of Family Medicine

Objective: The goal of this study was to determine the frequency and factors associated with adult immunization in patients visiting family medicine clinics at a tertiary care hospital in Karachi.
Methods: A cross-sectional study was conducted from March 2014 to March 2015 in a tertiary care hospital in Karachi, Pakistan. Participants more than 18 years were invited to participate in the study. A pretested questionnaire was used to collect information. Data were entered and analyzed using IBM SPSS Statistics for Windows, version 19.0 (Armonk, NY: IBM Corp).
Results: A total of 340 patients were surveyed. The majority of patients …

Pattern And Determinants Of Contraceptive Usage Among Women Of Reproductive Age From The Digo Community Residing In Kwale, Kenya: Results From A Cross-Sectional Household Survey, Vernon Mochache, Amyn Lakhani, Hajara El-Busaidy, Marleen Temmerman, Peter Gichangi

Family Medicine, East Africa

Background: Contraceptive usage has been associated with improved maternal and child health (MCH) outcomes. Despite significant resources being allocated to programs, there has been sub-optimal uptake of contraception, especially in the developing world. It is important therefore, to granulate factors that determine uptake and utilization of contraceptive services so as to inform effective programming.

Methods: Between March and December 2015, we conducted a cross-sectional survey among women of reproductive age (WRA) from the Digo community residing in Kwale County, Kenya. The study aimed to describe the pattern and determinants of contraceptive usage in this population. Respondents were selected using stratified, …

Health Literacy In Pakistan: Exploring New Ways Of Addressing An Old Challenge, Saniya Raghib Sabzwari

Department of Family Medicine

Pakistan continues to struggle with low health literacy that often results in late presentation of disease, poor adherence to treatment and meagre understanding of wellness and disease prevention. In a country burdened by diseases of the developing and the developed world, with poor healthcare infrastructure and low literacy levels improving healthcare literacy could have major influence on health and wellness of our masses. Utilising our rapidly expanding mobile technology and media for dissemination of health information is a viable solution. Public service announcements for media and health information apps for mobile technology can be developed by the government, health sector …

Human Cytomegalovirus: A Neglected Public Health Area Of Significant Relevance To Women, The Foetus And New Born. Time For Action!, Amna Rehana Siddiqui, Saira Ibrahim, Anwar Ali Siddiqui, Paul Moss, El-Nasir Lalani

Community Health Sciences

No abstract provided.

Multicomponent Intervention Versus Usual Care For Management Of Hypertension In Rural Bangladesh, Pakistan And Sri Lanka: Study Protocol For A Cluster Randomized Controlled Trial., Tazeen H. Jafar, Imtiaz Jehan, H. Asita De Silva, Aliya Naheed, Mihir Gandhi, Pryseley Assam, Eric A. Finkelstein, Helena Legido Quigley, Marcel Bilger, Aamir Hameed, John David Clemens, Shah Ebrahim, Elizabeth L. Turner, Anuradhani Kasturiratne

Community Health Sciences

BACKGROUND:

High blood pressure (BP) is the leading attributable risk for cardiovascular disease (CVD). In rural South Asia, hypertension continues to be a significant public health issue with sub-optimal BP control rates. The goal of the trial is to compare a multicomponent intervention (MCI) to usual care to evaluate the effectiveness and cost-effectiveness of the MCI for lowering BP among adults with hypertension in rural communities in Bangladesh, Pakistan and Sri Lanka.

METHODS/DESIGN:

This study is a stratified, cluster randomized controlled trial with a qualitative component for evaluation of processes and stakeholder feedback. The MCI has five components: (1) home …