Post-intervention acceptability of multicomponent intervention for management of hypertension in rural Bangladesh, Pakistan, and Sri Lanka- a qualitative study.

<h4>Background</h4>COBRA-BPS (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan, Sri Lanka), a multicomponent, community health-worker (CHW)-led hypertension management program, has been shown to be effective in rural communities in South Asia. This paper presents the a...

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Main Authors: Tazeen H Jafar, Saeideh Tavajoh, H Asita de Silva, Aliya Naheed, Imtiaz Jehan, Chamini Kanatiwela de Silva, Nantu Chakma, Maryam Huda, Helena Legido-Quigley, COBRA-BPS Study Group
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0280455&type=printable
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author Tazeen H Jafar
Saeideh Tavajoh
H Asita de Silva
Aliya Naheed
Imtiaz Jehan
Chamini Kanatiwela de Silva
Nantu Chakma
Maryam Huda
Helena Legido-Quigley
COBRA-BPS Study Group
author_facet Tazeen H Jafar
Saeideh Tavajoh
H Asita de Silva
Aliya Naheed
Imtiaz Jehan
Chamini Kanatiwela de Silva
Nantu Chakma
Maryam Huda
Helena Legido-Quigley
COBRA-BPS Study Group
author_sort Tazeen H Jafar
collection DOAJ
description <h4>Background</h4>COBRA-BPS (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan, Sri Lanka), a multicomponent, community health-worker (CHW)-led hypertension management program, has been shown to be effective in rural communities in South Asia. This paper presents the acceptability of COBRA-BPS multicomponent intervention among the key stakeholders.<h4>Methods</h4>We conducted post-implementation interviews of 87 stakeholder including 23 community health workers (CHWs), 19 physicians and 45 patients in 15 rural communities randomized to COBRA-BPS multicomponent intervention in in Bangladesh, Pakistan, and Sri Lanka. We used Theoretical Framework for Acceptability framework (TFA) with a focus on affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness and self-efficacy.<h4>Results</h4>COBRA-BPS multicomponent intervention was acceptable to most stakeholders. Despite some concerns about workload, most CHWs were enthusiastic and felt empowered. Physicians appreciated the training sessions and felt trusted by their patients. Patients were grateful to receive the intervention and valued it. However, patients in Pakistan and Bangladesh expressed the need for supplies of free medicines from the primary health facilities, while those in Sri Lanka were concerned about supplies' irregularities. All stakeholders favoured scaling-up COBRA-BPS at a national level.<h4>Conclusions</h4>COBRA-BPS multicomponent intervention is acceptable to the key stakeholders in Bangladesh, Pakistan and Sri Lanka. Community engagement for national scale-up of COBRA-BPS is likely to be successful in all three countries.
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spelling doaj-art-c53931efb22c466eac6535ce145a9e902025-08-20T02:33:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01181e028045510.1371/journal.pone.0280455Post-intervention acceptability of multicomponent intervention for management of hypertension in rural Bangladesh, Pakistan, and Sri Lanka- a qualitative study.Tazeen H JafarSaeideh TavajohH Asita de SilvaAliya NaheedImtiaz JehanChamini Kanatiwela de SilvaNantu ChakmaMaryam HudaHelena Legido-QuigleyCOBRA-BPS Study Group<h4>Background</h4>COBRA-BPS (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan, Sri Lanka), a multicomponent, community health-worker (CHW)-led hypertension management program, has been shown to be effective in rural communities in South Asia. This paper presents the acceptability of COBRA-BPS multicomponent intervention among the key stakeholders.<h4>Methods</h4>We conducted post-implementation interviews of 87 stakeholder including 23 community health workers (CHWs), 19 physicians and 45 patients in 15 rural communities randomized to COBRA-BPS multicomponent intervention in in Bangladesh, Pakistan, and Sri Lanka. We used Theoretical Framework for Acceptability framework (TFA) with a focus on affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness and self-efficacy.<h4>Results</h4>COBRA-BPS multicomponent intervention was acceptable to most stakeholders. Despite some concerns about workload, most CHWs were enthusiastic and felt empowered. Physicians appreciated the training sessions and felt trusted by their patients. Patients were grateful to receive the intervention and valued it. However, patients in Pakistan and Bangladesh expressed the need for supplies of free medicines from the primary health facilities, while those in Sri Lanka were concerned about supplies' irregularities. All stakeholders favoured scaling-up COBRA-BPS at a national level.<h4>Conclusions</h4>COBRA-BPS multicomponent intervention is acceptable to the key stakeholders in Bangladesh, Pakistan and Sri Lanka. Community engagement for national scale-up of COBRA-BPS is likely to be successful in all three countries.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0280455&type=printable
spellingShingle Tazeen H Jafar
Saeideh Tavajoh
H Asita de Silva
Aliya Naheed
Imtiaz Jehan
Chamini Kanatiwela de Silva
Nantu Chakma
Maryam Huda
Helena Legido-Quigley
COBRA-BPS Study Group
Post-intervention acceptability of multicomponent intervention for management of hypertension in rural Bangladesh, Pakistan, and Sri Lanka- a qualitative study.
PLoS ONE
title Post-intervention acceptability of multicomponent intervention for management of hypertension in rural Bangladesh, Pakistan, and Sri Lanka- a qualitative study.
title_full Post-intervention acceptability of multicomponent intervention for management of hypertension in rural Bangladesh, Pakistan, and Sri Lanka- a qualitative study.
title_fullStr Post-intervention acceptability of multicomponent intervention for management of hypertension in rural Bangladesh, Pakistan, and Sri Lanka- a qualitative study.
title_full_unstemmed Post-intervention acceptability of multicomponent intervention for management of hypertension in rural Bangladesh, Pakistan, and Sri Lanka- a qualitative study.
title_short Post-intervention acceptability of multicomponent intervention for management of hypertension in rural Bangladesh, Pakistan, and Sri Lanka- a qualitative study.
title_sort post intervention acceptability of multicomponent intervention for management of hypertension in rural bangladesh pakistan and sri lanka a qualitative study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0280455&type=printable
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