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Title: Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial
Authors: Kimaiyo Sylvester
Vedanthan Rajesh
Kamano Jemima
Naanyu Violet
Delong Allison K
Were Martin C
Finkelstein Eric A
Menya Diana
Akwanalo Constantine O.
Bloomfield Gerald S
Binanay Cynthia
Velazquez Eric J
Hogan Joseph W
Horowitz Carol R
Inui Thomas S
Fuster Valentin
Keywords: Hypertension
Linkage to care
Retention in care
Community health workers
Tailored Behavioral Communication
Smartphone Technology
Issue Date: 27-Apr-2017
Publisher: BMC
Abstract: 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.
Appears in Collections:School of Medicine

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