Adu-Gyamfi Raphael, Enos Juliana, Yeboah Kwame, Shabanova Veronika, Hawley Nicola, Alangea Ogum Deda, Agyei Nkansah Adwoa, Paintsil Elijah, Torpey Kwasi
School of Public Health, University of Ghana, Accra, Ghana.
Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
PLoS One. 2024 May 3;19(5):e0302016. doi: 10.1371/journal.pone.0302016. eCollection 2024.
Although AIDS-related deaths have reduced with increased access to antiretroviral care, cardiovascular disease-related morbidities among persons living with HIV are rising. Contributing to this is the higher incidence of Hypertension among Persons Living with HIV. The duration of exposure to the virus and antiretroviral drugs plays a vital role in the pathogenesis, putting perinatally infected children and adolescents at higher risk than behaviorally-infected ones, supporting the calls for increased surveillance of Hypertension among them. Despite the availability of guidelines to support this surveillance, the blood pressure (BP) of adolescents living with HIV (ADLHIV) is not checked during clinical visits. This study aims to assess the effect of a theory-based intervention on healthcare workers' adherence to the guidelines for hypertension screening among adolescents.
A multi-facility cluster-randomized study will be conducted. The clusters will be 20 antiretroviral therapy sites in the Greater Accra Region of Ghana with the highest adolescent caseload. Data will be extracted from the folders of adolescents (10-17 years) who received care in these facilities six months before the study. The ART staff of intervention facilities will receive a multicomponent theory of planned behaviour-based intervention. This will include orientation on hypertension risk among ADLHIV, provision of job aids and pediatric sphygmomanometers. Six months after the intervention, the outcome measure will be the change from baseline in the proportion of ADLHIV whose BP was checked during clinical visits. The calculated sample size is 400 folders.
This study will generate evidence on the effectiveness of a multicomponent theory-based intervention for improving the implementation of clinical practice guidelines.
PACTR202205641023383.
尽管随着抗逆转录病毒治疗的可及性增加，与艾滋病相关的死亡人数有所减少，但艾滋病毒感染者中与心血管疾病相关的发病率却在上升。艾滋病毒感染者中高血压发病率较高是导致这一情况的原因之一。病毒和抗逆转录病毒药物的暴露时间在发病机制中起着至关重要的作用，使围产期感染的儿童和青少年比行为感染的儿童和青少年面临更高的风险，这支持了加强对他们进行高血压监测的呼吁。尽管有支持这种监测的指南，但艾滋病毒感染青少年（ADLHIV）在临床就诊时并未检查血压。本研究旨在评估基于理论的干预措施对医护人员遵守青少年高血压筛查指南的影响。
将进行一项多机构整群随机研究。整群将是加纳大阿克拉地区20个抗逆转录病毒治疗点，这些治疗点的青少年病例数最多。数据将从研究前六个月在这些机构接受治疗的青少年（10 - 17岁）的病历中提取。干预机构的抗逆转录病毒治疗工作人员将接受基于计划行为多成分理论的干预。这将包括关于ADLHIV中高血压风险的培训、提供工作辅助工具和儿童血压计。干预六个月后，结果指标将是临床就诊时检查血压的ADLHIV比例相对于基线的变化。计算得出的样本量为400份病历。
本研究将为基于多成分理论的干预措施改善临床实践指南实施效果提供证据。
PACTR202205641023383。
