Alternative community-led intervention to improve uptake of cataract surgery services in rural Tanzania-the Dodoma Community Cataract Acceptance Trial (DoCCAT): A Protocol for intervention co-designing and implementation in a cluster-randomised controlled trial

Abstract Introduction Age-related lens opacification (cataract) remains the leading cause of visual impairment and blindness worldwide. In low- and middle-income countries, utilization of cataract surgical services is often limited despite community-based outreach programs. Community-led research, whereby researchers and community members collaboratively co-design interventions, is an approach that ensure the interventions are locally relevant and that their implementation is feasible and socially accepted in the targeted contexts. Community-led interventions have the potential to increase cataract surgery uptake if done appropriately. In this study once the intervention is co-designed it will be implemented through a cluster randomised controlled trial (cRCT) with ward as a unit of randomization. Methods and Analysis This is a mixed-method intervention study with the qualitative phase for co-designing of the intervention and the quantitative phase for effective assessment of the developed community-led intervention through a cRCT in 80 rural wards of Dodoma region, Tanzania (40 Intervention). The ‘intervention package’ will be developed through participatory community meetings and ongoing evaluation and modification of the intervention based on its impact on service utilization. Leask’s four stages of intervention co-creation will guide the development within Rifkin’s CHOICE framework. The primary outcomes are two: the number of patients attending eye disease screening camps, and the number of patients accepting cataract surgery. NVivo version 12 will be used for qualitative data analysis and Stata Version 12 for Quantitative data.