Scaling-up and scaling-out the Systems Analysis and Improvement Approach to optimize the hypertension diagnosis and care cascade for HIV infected individuals (SCALE SAIA-HTN): a stepped-wedge cluster randomized trial

Carmen E. Hazim,Igor Dobe,Stephen Pope,Kristjana H. Ásbjörnsdóttir,Orvalho Augusto, Fernando Pereira Bruno,Sergio Chicumbe,Norberto Lumbandali, Inocêncio Mate, Elso Ofumhan, Sam Patel, Riaze Rafik,Kenneth Sherr, Veronica Tonwe,Onei Uetela, David Watkins,Sarah Gimbel,Ana O. Mocumbi

Implementation Science Communications(2024)

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Abstract
Undiagnosed and untreated hypertension is a main driver of cardiovascular disease and disproportionately affects persons living with HIV (PLHIV) in low- and middle-income countries. Across sub-Saharan Africa, guideline application to screen and manage hypertension among PLHIV is inconsistent due to poor service readiness, low health worker motivation, and limited integration of hypertension screening and management within HIV care services. In Mozambique, where the adult HIV prevalence is over 13 NCT05002322 (registered 02/15/2023).
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Key words
Systems analysis and improvement approach (SAIA),Hypertension,HIV,Service integration,RE-AIM,CFIR,Process mapping,Cascade analysis,Continuous quality improvement,Stepped wedge
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