Global implementation research capacity building to address cardiovascular disease: An assessment of efforts in eight countries

• Type of Material: Article
• Authors: Mary Beth Weber, Emory University; Ana A. Bauman, Washington University in St. Louis; Ashlin Rakhra, New York University; Constantine Akwanalo, Moi Teaching and Referral Hospital; Kezia Gladys Amaning Adjei, Kwame Nkrumah University of Science and Technology; Josephine Andesia, Academic Model Providing Access to Healthcare; Kingsley Apusiga, Kwame Nkrumah University of Science and Technology; Duc A. Ha, Vietnam Ministry of Health; Mina C. Hosseinipour, University of North Carolina at Chapel Hill; Adamson S. Muula, University of Malawi; Hoa L. Nguyen, University of Massachusetts; LeShawndra N. Price, National Institutes of Health; Manuel Ramirez-Zea, Institute of Nutrition of Central America and Panama; Annette L. Pitzpatrick, University of Washington; Meredith P. Fort, University of Colorado-Anschutz Medical Campus
• Language: English
• Date: 2023-09-14
• Publisher: PLOS
• Publication Version: Final Published Version
• Copyright Statement: 2023, PLOS
• License: Creative Commons Universal : Public Domain Dedication
• Final Published Version (URL): https://doi.org/10.1371%2Fjournal.pgph.0002237
• Title of Journal or Parent Work: PLOS Global Public Health
• Volume: 3
• Issue: 9
• Start Page: e0002237
• Grant/Funding Information: The research reported in this publication was supported by the National Heart, Lung, and Blood Institute (NHLBI) under award numbers HL136789, HL136790, HL136791, HL138631, HL138635, HL138638, HL138647, and HL151310. The content is solely the responsibility of the authors and does not necessarily represent the official view of the NHLBI, the National Institute of Allergy and Infectious Diseases, the National Institutes of Health or the U.S. Department of Health and Human Services.
• Keywords: Rwanda; Nepal; Vietnam; Kenya; Ghana; Malawi; Guatemala; India; implementation; Cardiovascular disease
• Research Categories: Health Sciences, Public Health

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 collaborating in recent years to establish a research and training infrastructure in dissemination and implementation to improve hypertension care. GRIT includes projects in Ghana, Guatemala, 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 infrastructure, (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 capacity building activities in each layer of the Capacity Pyramid, with the largest number of activities 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 methods 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 maintained. The GRIT Consortium is a model for planning capacity building in LMICs.