Abstract:
Cardiovascular diseases are the leading causes of morbidity and mortality worldwide, but
implementation of evidence-based interventions for risk factors such as hypertension is
lacking, particularly in low and middle income countries (LMICs). Building implementation
research capacity in LMICs is required to overcome this gap. Members of the Global
Research on Implementation and Translation Science (GRIT) Consortium have been col-
laborating in recent years to establish a research and training infrastructure in dissemination
and implementation to improve hypertension care. GRIT includes projects in Ghana, Guate-
mala, India, Kenya, Malawi, Nepal, Rwanda, and Vietnam. We collected data from each site
on capacity building activities using the Potter and Brough (2004) model, mapping formal
and informal activities to develop (a) structures, systems and roles, (b) staff and infrastruc-
ture, (c) skills, and (d) tools. We captured information about sites’ needs assessments and
metrics plus program adaptations due to the COVID-19 pandemic. All sites reported capac-
ity building activities in each layer of the Capacity Pyramid, with the largest number of activi-
ties in the Skills and Tools categories, the more technical and easier to implement
categories. All sites included formal and informal training to build Skills. All sites included a
baseline needs assessment to guide capacity building activities or assess context and
inform intervention design. Sites implementing evidence-based hypertension interventions used common implementation science frameworks to evaluate implementation outcomes.
Although the COVID-19 pandemic affected timelines and in-person events, all projects were
able to pivot and carry out planned activities. Although variability in the activities and meth-
ods used existed, GRIT programs used needs assessments to guide locally appropriate
design and implementation of capacity building activities. COVID-19 related changes were
necessary, but strong collaborations and relationships with health ministries were main-
tained. The GRIT Consortium is a model for planning capacity building in LMICs
