Digital Commons Network^™

Introducing Sonhr-Reporting Guidelines For Social Networks In Health Research, Douglas A. Luke, Edward Tsai, Bobbi J. Carothers, Sara Malone, Beth Prusaczyk, Todd B. Combs, Mia T Vogel, Jennifer Watling Neal, Zachary P. Neal

2020-Current year OA Pubs

OBJECTIVE: The overall goal of this work is to produce a set of recommendations (SoNHR-Social Networks in Health Research) that will improve the reporting and dissemination of social network concepts, methods, data, and analytic results within health sciences research.

METHODS: This study used a modified-Delphi approach for recommendation development consistent with best practices suggested by the EQUATOR health sciences reporting guidelines network. An initial set of 28 reporting recommendations was developed by the author team. A group of 67 (of 147 surveyed) experienced network and health scientists participated in an online feedback survey. They rated the clarity and importance of …

Development Of A Social And Environmental Determinants Of Health Informatics Maturity Model, Juan C Espinoza, Shruti Sehgal, Jimmy Phuong, Neil Bahroos, Justin Starren, Adam Wilcox, Daniella Meeker

2020-Current year OA Pubs

INTRODUCTION: Integrating social and environmental determinants of health (SEDoH) into enterprise-wide clinical workflows and decision-making is one of the most important and challenging aspects of improving health equity. We engaged domain experts to develop a SEDoH informatics maturity model (SIMM) to help guide organizations to address technical, operational, and policy gaps.

METHODS: We established a core expert group consisting of developers, informaticists, and subject matter experts to identify different SIMM domains and define maturity levels. The candidate model (v0.9) was evaluated by 15 informaticists at a Center for Data to Health community meeting. After incorporating feedback, a second evaluation round …

Promoting Rigor And Sustainment In Implementation Science Capacity Building Programs: A Multi-Method Study., Amy G Huebschmann, Shelly Johnston, Rachel Davis, Bethany M Kwan, Elvin Geng, Debra Haire-Joshu, Brittney Sandler, Demetria M Mcneal, Ross C Brownson, Borsika A Rabin

2020-Current year OA Pubs

BACKGROUND: The field of Implementation science (IS) continues to evolve, and the number and type of IS capacity building Programs (ISCBPs) are in flux. These changes push the field to revisit the accepted IS competencies and to guide sustainment of ISCBPs. Our objectives were: (1) compare characteristics of current ISCBPs; (2) identify recommendations to support ISCBP sustainment; (3) measure how often ISCBPs address IS competencies; (4) identify novel and important IS competencies for the field.

METHOD: This multi-method study included ISCBPs delivering structured, longitudinal IS training, excluding single courses and brief workshops. We used three complementary methods to meet our …

Sodium Content And Labelling Of Packaged Foods And Beverages In Nigeria: A Cross-Sectional Study, Adedayo E Ojo, Mark D Huffman, Et Al.

2020-Current year OA Pubs

Increased consumption of unhealthy processed foods, particularly those high in sodium, is a major risk factor for cardiovascular diseases. The nutrition information on packaged foods can help guide consumers toward products with less sodium and support government actions to improve the healthiness of the food supply. The aims of this study were to estimate the proportion of packaged foods displaying nutrition information for sodium and other nutrients specified by Nigerian nutrition labelling regulations and to determine the amount of sodium in packaged foods sold in Nigeria using data from the nutritional information panel. Data were collected from November 2020 to …

Topics And Sentiment Surrounding Vaping On Twitter And Reddit During The 2019 E-Cigarette And Vaping Use-Associated Lung Injury Outbreak: Comparative Study, Dezhi Wu, Erin Kasson, Avineet Kumar Singh, Yang Ren, Nina Kaiser, Ming Huang, Patricia A Cavazos-Rehg

2020-Current year OA Pubs

BACKGROUND: Vaping or e-cigarette use has become dramatically more popular in the United States in recent years. e-Cigarette and vaping use-associated lung injury (EVALI) cases caused an increase in hospitalizations and deaths in 2019, and many instances were later linked to unregulated products. Previous literature has leveraged social media data for surveillance of health topics. Individuals are willing to share mental health experiences and other personal stories on social media platforms where they feel a sense of community, reduced stigma, and empowerment.

OBJECTIVE: This study aimed to compare vaping-related content on 2 popular social media platforms (ie, Twitter and Reddit) …

Prevalence Estimates Of Trafficking In Persons Using Statistical Definitions: A Cross-Sectional High-Risk Community Survey In Cape Town, South Africa, Rumi Kato Price, Annah K Bender, Floriana H Milazzo, Edna G Rich, Nicolette V Roman, Sheldon X Zhang, Erica L Koegler

2020-Current year OA Pubs

OBJECTIVES: Current research on trafficking in persons (TIP) relies heavily on legal and prosecutorial definitions. A public health approach has called for population-level assessment; however, identification of TIP victims lacks a standardised operational definition. This study applied the Prevalence Reduction Innovation Forum (PRIF) statistical definitions, developed by the US Department of State, to a community survey in Cape Town, South Africa.

DESIGNS: A high-risk sampling strategy was used. TIP screening questions from two instruments were matched with PRIF domain indicators to generate prevalence estimates. Sensitivity, specificity and receiver operating characteristics analyses were conducted to assess the performance of the two …

Mindfulness Training For Depressed Older Adults Using Smartphone Technology: Protocol For A Fully Remote Precision Clinical Trial, Abigail Schweiger, Thomas L Rodebaugh, Eric J Lenze, Katie Keenoy, Jason Hassenstab, Jeanne Kloeckner, Torie R Gettinger, Ginger E Nicol

2020-Current year OA Pubs

BACKGROUND: Precision medicine, optimized interventions, and access to care are catchphrases for the future of behavioral treatments. Progress has been slow due to the dearth of clinical trials that optimize interventions' benefits, individually tailor interventions to meet individual needs and preferences, and lead to rapid implementation after effectiveness is demonstrated. Two innovations have emerged to meet these challenges: fully remote trials and precision clinical trials.

OBJECTIVE: This paper provides a detailed description of Mindful MyWay, a study designed to test online mindfulness training in older adults with depression. Consistent with the concept of fully remote trials using a smartphone app, …

Gynecologic Oncology Patient Perspectives And Knowledge On Advance Care Planning: A Quality Improvement Intervention, Sarah P. Huepenbecker, Sophia Lewis, Mark C. Valentine, Marguerite L. Palisoul, Premal H. Thaker, Andrea R. Hagemann, Carolyn K. Mccourt, Katherine C. Fuh, Matthew A. Powell, David G. Mutch, Lindsay M. Kuroki

2020-Current year OA Pubs

OBJECTIVES: Assess and improve advance care planning (ACP) awareness and uptake among gynecologic oncology patients.

METHODS: Using a quality improvement Plan-Do-Check-Act framework, we completed a single institution needs assessment and intervention. The needs assessment was a 26-question survey assessing baseline ACP knowledge and preferences of gynecologic oncology patients. We used this survey to implement an outpatient intervention in which patients were offered ACP resources (pamphlet, discussion with their gynecologic oncologist, and/or social work referral). We conducted a post-intervention survey among patients who had and had not received ACP resource(s) to assess whether our intervention increased ACP knowledge, discussions, or uptake. …

Help Is Available: Supporting Mental Wellness Through Peer Health Navigation With Young Black Men Who Have Sex With Men With Hiv, Donald R Gerke, Jeff Glotfelty, Maria Freshman, Julia Schlueter, Alex Ochs, Katie Plax

2020-Current year OA Pubs

Young black men who have sex with men (YBMSM) with HIV experience disproportionate rates of trauma, incarceration, poverty, racial discrimination, and homophobia. The synergistic effects of these adverse experiences, along with increased rates of mental health disorders, increase their risk for poor health. To address this need, the study authors adapted a current HIV service model to include a peer-health navigation intervention (WITH U) to attend to behavioral health, health literacy, linkage to services, and psychosocial support for YBMSM with HIV. This longitudinal, mixed-methods, nonexperimental study reports on the mental health burden among participants and the association between participation in …

Exit Rates Of Accountable Care Organizations That Serve High Proportions Of Beneficiaries Of Racial And Ethnic Minority Groups, Sunny C Lin, Karen E Joynt Maddox, Andrew M Ryan, Nicholas Moloci, Addison Shay, John Malcolm Hollingsworth

2020-Current year OA Pubs

Importance: The Medicare Shared Savings Program provides financial incentives for accountable care organizations (ACOs) to reduce costs of care. The structure of the shared savings program may not adequately adjust for challenges associated with caring for patients with high medical complexity and social needs, a population disproportionately made up of racial and ethnic minority groups. If so, ACOs serving racial and ethnic minority groups may be more likely to exit the program, raising concerns about the equitable distribution of potential benefits from health care delivery reform efforts.

Objective: To evaluate whether ACOs with a high proportion of beneficaries of racial …

Facilitators Of Multisector Collaboration For Delivering Cancer Control Interventions In Rural Communities: A Descriptive Qualitative Study, Peg Allen, Callie Walsh-Bailey, Jean Hunleth, Bobbi J Carothers, Ross C Brownson

2020-Current year OA Pubs

PURPOSE AND OBJECTIVES: Multisector collaboration is a widely promoted strategy to increase equitable availability, access, and use of healthy foods, safe places for physical activity, social supports, and preventive health care services. Yet fewer studies and resources exist for collaboration among governmental and nongovernmental agencies to address public problems in rural areas, despite an excess burden of risk factors for cancer morbidity and mortality. We aimed to learn about cancer prevention activities and collaboration facilitators among rural informal interagency networks.

EVALUATION METHODS: In 2020, researchers conducted semistructured interviews with staff from rural public health and social services agencies, community health …

Quantifying Inequities In Covid-19 Vaccine Distribution Over Time By Social Vulnerability, Race And Ethnicity, And Location: A Population-Level Analysis In St. Louis And Kansas City, Missouri, Aaloke Mody, Cory Bradley, Salil Redkar, Branson Fox, Ingrid Eshun-Wilson, Matifadza G. Hlatshwayo, Anne Trolard, Khai Hoan Tram, Lindsey M. Filiatreau, Franda Thomas, Matt Haslam, George Turabelidze, Vetta Sanders-Thompson, William G. Powderly, Elvin H. Geng

2020-Current year OA Pubs

BACKGROUND: Equity in vaccination coverage is a cornerstone for a successful public health response to COVID-19. To deepen understanding of the extent to which vaccination coverage compares with initial strategies for equitable vaccination, we explore primary vaccine series and booster rollout over time and by race/ethnicity, social vulnerability, and geography.

METHODS AND FINDINGS: We analyzed data from the Missouri Department of Health and Senior Services on all COVID-19 vaccinations administered across 7 counties in the St. Louis region and 4 counties in the Kansas City region. We compared rates of receiving the primary COVID-19 vaccine series and boosters relative to …

Examination Of The Interaction Between Parental Military-Status And Race Among Non-Hispanic Black And Non-Hispanic White Adolescents With Overweight/Obesity, M K Higgins Neyland, Denise E Wilfley, Et Al.

2020-Current year OA Pubs

OBJECTIVES: Adolescent military-dependents experience distinct risk and protective factors, which may necessitate additional clinical considerations. In civilian youth, overweight/obesity is associated with eating, internalizing, and externalizing difficulties, with some studies reporting more difficulties among non-Hispanic White (vs. non-Hispanic Black) youth. It is unknown if these disparities exist among adolescent military-dependents, or between civilian and military-dependent youth.

METHODS: Non-Hispanic Black (187 civilian, 38 military-dependent) and non-Hispanic White (205 civilian, 84 military-dependent) adolescents with overweight/obesity (14.7 ± 1.6 years; 73.9% girls; body mass index adjusted for age and sex 1.9 ± 0.5) completed a disordered-eating interview; parents completed a measure assessing their …

Aging With Disability Symptoms And Ability To Participate In, And Satisfaction With, Social Participation Among Persons Aged 45-64, Michelle Putnam, Kerri A. Morgan, Rachel Heeb, Yan Yan, Szu-Wei Chen, Susan L Stark

Open Access Publications

Pain, fatigue, and depression, considered aging with disability (AwD) symptoms, are known to be substantially higher among middle-aged adults with long-term disability compared to their age peers. Participation has been recognized as an important component of health. This cohort survey study reports findings on the relationship between AwD symptoms and ability to participate in, and satisfaction with participation in, social roles and activities using PROMIS measures. Data were collected at three time points from individuals aged 45-64 with an average of two decades of disability duration and primarily living in the state of Missouri, USA. This study reports on Time …

Analysis Of Stimulant Prescriptions And Drug-Related Poisoning Risk Among Persons Receiving Buprenorphine Treatment For Opioid Use Disorder, Carrie M Mintz, Kevin Y Xu, Ned J Presnall, Sarah M Hartz, Frances R Levin, Jeffrey F Scherrer, Laura J Bierut, Richard A Grucza

2020-Current year OA Pubs

Importance: Stimulant medication use is common among individuals receiving buprenorphine for opioid use disorder (OUD). Associations between prescription stimulant use and treatment outcomes in this population have been understudied.

Objectives: To investigate whether use of prescription stimulants was associated with (1) drug-related poisoning and (2) buprenorphine treatment retention.

Design, Setting, and Participants: This retrospective, recurrent-event cohort study with a case-crossover design used a secondary analysis of administrative claims data from IBM MarketScan Commercial and Multi-State Medicaid databases from January 1, 2006, to December 31, 2016. Primary analyses were conducted from March 1 through August 31, 2021. Individuals aged 12 to …

The Geriatric Emergency Care Applied Research (Gear) Network Approach: A Protocol To Advance Stakeholder Consensus And Research Priorities In Geriatrics And Dementia Care In The Emergency Department, Ula Hwang, Christopher Carpenter, Scott Dresden, Jeffrey Dussetschleger, Angela Gifford, Ly Hoang, Jesseca Leggett, Armin Nowroozpoor, Zachary Taylor, Manish Shah, The Gear And Gear 2.0 Networks

Open Access Publications

INTRODUCTION: Increasingly, older adults are turning to emergency departments (EDs) to address healthcare needs. To achieve these research demands, infrastructure is needed to both generate evidence of intervention impact and advance the development of implementation science, pragmatic trials evaluation and dissemination of findings from studies addressing the emergency care needs of older adults. The Geriatric Emergency Care Applied Research Network (https://gearnetwork.org) has been created in response to these scientific needs-to build a transdisciplinary infrastructure to support the research that will optimise emergency care for older adults and persons living with dementia.

METHODS AND ANALYSIS: In this paper, we describe our …

Collaboration Networks Of The Implementation Science Centers For Cancer Control: A Social Network Analysis, Rebekah R Jacob, Ariella R Korn, Grace C Huang, Douglas Easterling, Daniel A Gundersen, Shoba Ramanadhan, Thuy Vu, Heather Angier, Ross C Brownson, Debra Haire-Joshu, April Y Oh, Robert Schnoll

2020-Current year OA Pubs

BACKGROUND: Multi-center research initiatives offer opportunities to develop and strengthen connections among researchers. These initiatives often have goals of increased scientific collaboration which can be examined using social network analysis.

METHODS: The National Cancer Institute (NCI)-funded Implementation Science Centers in Cancer Control (ISC

RESULTS: Of the 192 invitees, 182 network members completed the survey (95%). The most prevalent roles were faculty (60%) and research staff (24%). Almost one-quarter (23%) of members reported advanced expertise in IS, 42% intermediate, and 35% beginner. Most members were female (69%) and white (79%). One-third (33%) of collaboration ties were among members from different centers. …

Washington University Magazine, December 2022

Washington University Magazine

No abstract provided.

Coping With Covid-19: Differences In Hope, Resilience, And Mental Well-Being Across U.S. Racial Groups, Carol Graham, Yung Chun, Bartram Hamilton, Stephen Roll, Wilbur Ross, Michal Grinstein-Weiss

Open Access Publications

OBJECTIVES: To explore if the COVID-19 pandemic revealed differences across racial groups in coping, resilience, and optimism, all of which have implications for health and mental well-being.

METHODS: We collect data obtained from four rounds of a national sample of 5,000 US survey respondents in each round from April 2020 to February 2021. Using logistic regression and fixed effects models, we estimate the pandemic impacts on COVID-19 related concerns, social distancing behaviors, and mental health/life satisfaction and optimism for racial/income groups.

RESULTS: Despite extreme income and health disparities before and during the COVID-19 outbreak, Blacks and Hispanics remain more resilient …

Perceptions Of Telemedicine And Costs Incurred By A Visit To A General Infectious Diseases Clinic: A Survey, Emily C. Evers, Stephanie A. Fritz, Graham A. Colditz, Jason P. Burnham

Open Access Publications

Background: The costs of attending in-person general infectious diseases clinics and preferences for visit type (telemedicine vs in-person) are not well known. We aimed to measure the time-related, monetary, social, and societal costs associated with travel to an in-person clinic visit and to assess patients' preferences, questions, and concerns regarding telemedicine.

Methods: Patients (≥18 years, living ≥25 miles from clinic at time of clinic visit) were recruited for this survey study from the general infectious diseases (ID) clinic at Washington University from June 2019 to February 2020. We calculated time and money potentially saved by telemedicine, as well as carbon …

Sustainability In Pediatric Hospitals: An Exploration At The Intersection Of Quality Improvement And Implementation Science, Sara Malone, Jason Newland, Sapna R Kudchadkar, Kim Prewitt, Virginia Mckay, Beth Prusaczyk, Enola Proctor, Ross C Brownson, Douglas A Luke

2020-Current year OA Pubs

BACKGROUND: Although new evidence-based practices are frequently implemented in clinical settings, many are not sustained, limiting the intended impact. Within implementation science, there is a gap in understanding sustainability. Pediatric healthcare settings have a robust history of quality improvement (QI), which includes a focus on continuation of change efforts. QI capability and sustainability capacity, therefore, serve as a useful concept for connecting the broader fields of QI and implementation science to provide insights on improving care. This study addresses these gaps in understanding of sustainability in pediatric settings and its relationship to QI.

METHODS: This is a cross-sectional observational study …

Aging With Long-Term Physical Disability: Cohort Analysis Of Survey Sample In The U.S., Kerri A Morgan, Michelle Putnam, Sandra M Espin-Tello, Marian Keglovits, Margaret Campbell, Yan Yan, Aimee Wehmeier, Susan Stark

2020-Current year OA Pubs

BACKGROUND: Chronic health conditions, secondary conditions, and decreasing functional ability related to aging and/or changes in underlying impairment may influence participation for persons aging with long-term physical disability (AwD).

OBJECTIVE: To examine sample integrity and baseline findings through exploration of associations of sociodemographic, health, and disability factors with social participation for persons AwD.

METHODS: This is a longitudinal cohort study following persons AwD over three years, reporting baseline cohort study data. A convenience sample of 474 persons AwD aged 45-65 reporting physical disability of ≥5 years' duration was recruited through community organizations and social media. The cohort was majority female …

Experiences Using A Multidisciplinary Model For Treating Injection Drug Use Associated Infections: A Qualitative Study, Nathanial S Nolan, Emily Gleason, Laura R Marks, Tracey Habrock-Bach, Stephen Y Liang, Michael J Durkin

2020-Current year OA Pubs

Background: Over the past two decades, the United States has experienced a dramatic increase in the rate of injection drug use, injection associated infections, and overdose mortality. A hospital-based program for treating opioid use disorder in people who inject drugs presenting with invasive infections was initiated at an academic tertiary care center in 2020. The goal of this program was to improve care outcomes, enhance patient experiences, and facilitate transition from the hospital to longer term addiction care. The purpose of this study was to interview two cohorts of patients, those admitted before vs. after initiation of this program, to …

"Provider Discretionary Power Practices To Support Implementation Of Patient-Centered Hiv Care In Lusaka, Zambia", Chanda Mwamba, Njekwa Mukamba, Anjali Sharma, Kasapo Lumbo, Marksman Foloko, Herbert Nyirenda, Sandra Simbeza, Kombatende Sikombe, Charles B Holmes, Izukanji Sikazwe, Carolyn Bolton Moore, Aaloke Mody, Elvin Geng, Laura K Beres

2020-Current year OA Pubs

INTRODUCTION: Traditional patient-provider relationships privilege the providers, as they possess the formal authority and clinical knowledge applied to address illness, but providers also have discretion over how they exercise their power to influence patients' services, benefits, and sanctions. In this study, we assessed providers' exercise of discretionary power in implementing patient-centered care (PCC) practices in Lusaka, Zambia.

METHODS: HIV clinical encounters between patients on antiretroviral therapy (ART) and providers across 24 public health facilities in Lusaka Province were audio recorded and transcribed verbatim. Using qualitative content analysis, we identified practices of discretionary power (DP) employed in the implementation of PCC …

A Perspective On Implementation Outcomes And Strategies To Promote The Uptake Of Covid-19 Vaccines, Meagan Pilar, A Rani Elwy, Larissa Lushniak, Grace Huang, Gabriella M Mcloughlin, Cole Hooley, Nisha Nadesan-Reddy, Brittney Sandler, Mosa Moshabela, Olakunle Alonge, Elvin Geng, Enola Proctor

2020-Current year OA Pubs

Recent articles have highlighted the importance of incorporating implementation science concepts into pandemic-related research. However, limited research has been documented to date regarding implementation outcomes that may be unique to COVID-19 vaccinations and how to utilize implementation strategies to address vaccine program-related implementation challenges. To address these gaps, we formed a global COVID-19 implementation workgroup of implementation scientists who met weekly for over a year to review the available literature and learn about ongoing research during the pandemic. We developed a hierarchy to prioritize the applicability of "lessons learned" from the vaccination-related implementation literature. We identified applications of existing implementation …

Using Innovation-Corps (I-Corps™) Methods To Adapt A Mobile Health (Mhealth) Obesity Treatment For Community Mental Health Settings, Rita Haddad, Carolina Badke D'Andrea, Amanda Ricchio, Bradley Evanoff, Elaine H Morrato, Joseph Parks, John W Newcomer, Ginger E Nicol

2020-Current year OA Pubs

BACKGROUND: We employed Innovation Corps (I-Corps™) methods to adaptation of a mobile health (mHealth) short-message-system (SMS) -based interactive obesity treatment approach (iOTA) for adults with severe mentall illness receiving care in community settings.

METHODS: We hypothesized "jobs to be done" in three broad stakeholder groups: "decision makers" (DM = state and community clinic administrators), "clinician consumers" (CC = case managers, peer supports, nurses, prescribers) and "service consumers" (SC = patients, peers and family members). Semistructured interviews (

RESULTS: Four themes emerged across groups: education, inertia, resources and ownership. Sub-themes in education and ownership differed between DM and CC groups on …

Sustainability Of Breastfeeding Interventions To Reduce Child Mortality Rates In Low, Middle-Income Countries: A Systematic Review Of Randomized Controlled Trials, Alexis Engelhart, Stacey Mason, Ucheoma Nwaozuru, Chisom Obiezu-Umeh, Victoria Carter, Thembekile Shato, Titilola Gbaja-Biamila, David Oladele, Juliet Iwelunmor

2020-Current year OA Pubs

Child mortality is the lowest it has ever been, but the burden of death in low- and middle-income countries (LMICs) is still prevalent, and the numbers average above the global mean. Breastfeeding contributes to the reduction of child mortality by improving chance of survival beyond childhood. Therefore, it is essential to examine how evidence-based breastfeeding interventions are being maintained in resource-constrained settings. Guided by Scheirer and Dearing's sustainability framework, the aim of this systematic review was to explore how evidence-based breastfeeding interventions implemented to address child mortality in LMICs are sustained. The literature search included randomized controlled trials (RCTs) of …

Social Needs, Chronic Conditions, And Health Care Utilization Among Medicaid Beneficiaries, Amy Mcqueen, Linda Li, Cynthia J. Herrick, Niko Verdecias, Derek S. Brown, Darrell J. Broussard, Rachel E. Smith, Matthew Kreuter

Open Access Publications

No abstract provided.

Development Of A Resource Guide To Help Patients Receive Appropriate Care, Erin D Solomon, Heidi Walsh, Meredith Parsons, Tristan Mcintosh, Jessica Mozersky, James M Dubois

Open Access Publications

After 10 years researching physician wrongdoing (i.e., sexual violations, improper prescribing, and unnecessary procedures), we developed a resource guide to help patients receive appropriate care and respond to inappropriate care. We gathered evaluative patient feedback, engaged physicians, and disseminated the guide. It is available at beforeyourvisit.org.

Exploring Contextual Factors Influencing The Implementation Of Evidence-Based Care For Hypertension In Rwanda: A Cross-Sectional Study Using The Coach Questionnaire, Ana Baumann, Cole Hooley, Charles Goss, Vincent Mutabazi, Angela Brown, Kenneth Schechtman, Marc Twagirumukiza, Lisa De Las Fuentes, Dominic Reeds, Makeda Williams, Eugene Mutimura, Anna Bergström, Aurore Nishimwe, Cecile Ingabire, Victor Davila-Roman

Open Access Publications

IMPORTANCE: Hypertension is the largest contributor to the Global Burden of Disease. In Rwanda, as in most low-income and middle-income countries, an increasing prevalence of hypertension and its associated morbidity and mortality is causing major healthcare and economic impact. Understanding healthcare systems context in hypertension care is necessary.

OBJECTIVE: To study the hypertension healthcare context as perceived by healthcare providers using the Context Assessment for Community Health (COACH) tool.

DESIGN: A cross-sectional cohort responded to the COACH questionnaire and a survey about hypertension training.

SETTING: Three tertiary care hospitals in Rwanda.

PARTICIPANTS: Healthcare professionals (n=223).

PRIMARY OUTCOMES AND MEASURES: The …