Implementing and Evaluating Community Health Worker-Led Cardiovascular Disease Risk Screening Intervention in Sub-Saharan Africa Communities: A Participatory Implementation Research Protocol

Kufre Okop (), Peter Delobelle, Estelle Victoria Lambert, Hailemichael Getachew, Rawleigh Howe, Kiya Kedir, Jean Berchmans Niyibizi, Charlotte Bavuma, Stephen Kasenda, Amelia C. Crampin, Abby C. King, Thandi Puoane and Naomi S. Levitt
Additional contact information
Kufre Okop: Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town 7700, South Africa
Peter Delobelle: Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town 7700, South Africa
Estelle Victoria Lambert: UCT Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
Hailemichael Getachew: Armauer Hansen Research Institute (AHRI), Addis Ababa P.O. Box 1005, Ethiopia
Rawleigh Howe: Armauer Hansen Research Institute (AHRI), Addis Ababa P.O. Box 1005, Ethiopia
Kiya Kedir: Armauer Hansen Research Institute (AHRI), Addis Ababa P.O. Box 1005, Ethiopia
Jean Berchmans Niyibizi: College of Medicine and Health Sciences, University of Rwanda, Kigali 4285, Rwanda
Charlotte Bavuma: School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali 4285, Rwanda
Stephen Kasenda: Malawi Epidemiology and Intervention Research Unit, Lilongwe P.O. Box 46, Malawi
Amelia C. Crampin: Malawi Epidemiology and Intervention Research Unit, Lilongwe P.O. Box 46, Malawi
Abby C. King: Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA
Thandi Puoane: School of Public Health, University of the Western Cape, Cape Town 7535, South Africa
Naomi S. Levitt: Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town 7700, South Africa

IJERPH, 2022, vol. 20, issue 1, 1-12

Abstract: The increasing burden of non-communicable diseases (NCDs), particularly cardiovascular diseases (CVD) in low- and middle-income countries (LMICs) poses a considerable threat to public health. Community-driven CVD risk screening, referral and follow-up of those at high CVDs risk is essential to supporting early identification, treatment and secondary prevention of cardiovascular events such as stroke and myocardial infarction. This protocol describes a multi-country study that aims to implement and evaluate a community health worker (CHW)-led CVD risk screening programme to enhance referral linkages within the local primary care systems in sub-Saharan Africa (SSA), using a participatory implementation science approach. The study builds upon a prior community-driven multicentre study conducted by the Collaboration for Evidence-based Health Care and Public Health in Africa (CEBHA+). This is a participatory implementation research. The study will leverage on the CVD risk citizen science pilot studies conducted in the four selected CEBHA+ project countries (viz. Ethiopia, Rwanda, Malawi, and South Africa). Through planned engagements with communities and health system stakeholders, CHWs and lay health worker volunteers will be recruited and trained to screen and identify persons that are at high risk of CVD, provide referral services, and follow-up at designated community health clinics. In each country, we will use a multi-stage random sampling to select and then screen 1000 study participants aged 35–70 years from two communities (one rural and one urban). Screening will be done using a simple validated non-laboratory-based CVD risk assessment mobile application. The RE-AIM model will be used in evaluating the project implementation outcomes, including reach, fidelity, adoption and perceived effectiveness. Developing the capacities of CHWs and lay health worker volunteers in SSA to support population-based, non-invasive population-based CVD risk prevention has the potential to impact on early identification, treatment and secondary prevention of CVDs in often under-resourced communities. Using a participatory research approach to implementing mobile phone-based CHW-led CVD risk screening, referral and follow-up in SSA will provide the evidence needed to determine the effectiveness of CVD risk screening and the potential for scaling up in the wider region.

Keywords: cardiovascular diseases; citizen science; CVD risk; screening; referral; community health workers; COVID-19; implementation science (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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