Abstract:
BACKGROUND:A large and compelling clinical evidence base has shown that integrated TB and HIV services leads to reduction in human immunodeficiency virus (HIV)- and tuberculosis (TB)-associated mortality and morbidity. Despite official policies and guidelines recommending TB and HIV care integration, its poor implementation has resulted in TB and HIV remaining the commonest causes of death in several countries in sub-Saharan Africa, including South Africa. This study aims to reduce mortality due to TB-HIV co-infection through a quality improvement strategy for scaling up of TB and HIV treatment integration in rural primary healthcare clinics in South Africa. METHODS:The study is designed as an open-label cluster randomized controlled trial. Sixteen clinic supervisors who oversee 40 primary health care (PHC) clinics in two rural districts of KwaZulu-Natal, South Africa will be randomized to either the control group (provision of standard government guidance for TB-HIV integration) or the intervention group (provision of standard government guidance with active enhancement of TB-HIV care integration through a quality improvement approach). The primary outcome is all-cause mortality among TB-HIV patients. Secondary outcomes include time to antiretroviral therapy (ART) initiation among TB-HIV co-infected patients, as well as TB and HIV treatment outcomes at 12 months. In addition, factors that may affect the intervention, such as conditions in the clinic and staff availability, will be closely monitored and documented. DISCUSSION:This study has the potential to address the gap between the establishment of TB-HIV care integration policies and guidelines and their implementation in the provision of integrated care in PHC clinics. If successful, an evidence-based intervention comprising change ideas, tools, and approaches for quality improvement could inform the future rapid scale up, implementation, and sustainability of improved TB-HIV integration across sub-Sahara Africa and other resource-constrained settings. TRIAL REGISTRATION:Clinicaltrials.gov, NCT02654613 . Registered 01 June 2015.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Naidoo K,Gengiah S,Yende-Zuma N,Padayatchi N,Barker P,Nunn A,Subrayen P,Abdool Karim SSdoi
10.1186/s13012-017-0661-1subject
Has Abstractpub_date
2017-11-13 00:00:00pages
129issue
1issn
1748-5908pii
10.1186/s13012-017-0661-1journal_volume
12pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Implementation of clinical research results is challenging, yet the responsibility for implementation is seldom addressed. The process from research to the use of clinical research results in health care can be facilitated by research funders. In this paper, we report the roles of ten Swedish research funder...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0290-5
更新日期:2015-07-17 00:00:00
abstract:BACKGROUND:The Dutch multidisciplinary sciatica guideline recommends that the team of professionals involved in sciatica care and the patient together decide on surgical or prolonged conservative treatment (shared decision making [SDM]). Despite this recommendation, SDM is not yet integrated in sciatica care. Existing ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-95
更新日期:2013-08-23 00:00:00
abstract:BACKGROUND:Evidence-based practice (EBP) implementation represents a strategic change in organizations that requires effective leadership and alignment of leadership and organizational support across organizational levels. As such, there is a need for combining leadership development with organizational strategies to s...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-017-0562-3
更新日期:2017-03-03 00:00:00
abstract:BACKGROUND:In 2011, Manitoba implemented a province-wide program of physician detailing and free sampling for generic atorvastatin to increase use of this generic statin. We examined the impact of this unique combined program of detailing and sampling for generic atorvastatin on the use and cost of statin medicines, ma...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0671-z
更新日期:2017-11-25 00:00:00
abstract:BACKGROUND:This study describes a collaborative planning approach that blends principles of community-based participatory research (CBPR) and intervention mapping to modify a healthcare manager intervention to a new patient population and provider group and to assess the feasibility and acceptability of this modified i...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-80
更新日期:2011-07-26 00:00:00
abstract:BACKGROUND:The adoption and diffusion of clinical information systems has become one of the critical benchmarks for achieving several healthcare organizational reform priorities, including home care, primary care, and integrated care networks. However, these systems are often strongly resisted by the same community tha...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-15
更新日期:2011-02-28 00:00:00
abstract:BACKGROUND:Ageing has become a worldwide reality and presents new challenges for the health-care system. Research has shown that potentially inappropriate prescribing, both potentially inappropriate medications and potentially prescribing omissions, is highly prevalent in older people, especially in the nursing home se...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-016-0394-6
更新日期:2016-03-11 00:00:00
abstract:BACKGROUND:Organizational factors are considered to be an important influence on health workers' uptake of interventions that improve their practices. These are additionally influenced by factors operating at individual and broader health system levels. We sought to explore contextual influences on worker motivation, a...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-43
更新日期:2009-07-23 00:00:00
abstract:BACKGROUND:National leaders recommend documenting social determinants of health and actions taken to address social determinants of health in electronic health records, and a growing body of evidence suggests the health benefits of doing so. However, little evidence exists to guide implementation of social determinants...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-019-0855-9
更新日期:2019-01-28 00:00:00
abstract:BACKGROUND:Translation of evidence-based interventions into hospital systems can provide immediate and substantial benefits to patient care and outcomes, but successful implementation is often not achieved. Existing literature describes a range of barriers and facilitators to the implementation process. This systematic...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0726-9
更新日期:2018-02-23 00:00:00
abstract:BACKGROUND:It is difficult to foster research utilization among allied health professionals (AHPs). Tailored, multifaceted knowledge translation (KT) strategies are now recommended but are resource intensive to implement. Employers need effective KT solutions but little is known about; the impact and viability of multi...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-8-132
更新日期:2013-11-13 00:00:00
abstract:PURPOSE:The purpose of this study was to undertake a systematic assessment of the need for research-based information by decision-makers working in community-based organizations. It is part of a more comprehensive knowledge transfer and exchange strategy that seeks to understand both the content required and the format...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-2-20
更新日期:2007-07-03 00:00:00
abstract:BACKGROUND:Implementation strategies are imperative for the successful adoption and sustainability of complex evidence-based public health practices. Creating a learning collaborative is one strategy that was part of a recently published compilation of implementation strategy terms and definitions. In partnership with ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0674-9
更新日期:2017-11-21 00:00:00
abstract:BACKGROUND:Considerable racial and socio-economic disparities exist in breast cancer. In spite of the existence of numerous evidence-based interventions (EBIs) aimed at reducing breast cancer screening barriers among the underserved, there is a lack of uptake or sub-optimal uptake of EBIs in community and clinical sett...
journal_title:Implementation science : IS
pub_type: 临床试验,杂志文章
doi:10.1186/s13012-015-0334-x
更新日期:2015-10-14 00:00:00
abstract:BACKGROUND:Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice. Several interventions have been shown to be effective in changing health care professionals' behaviour, but heterogeneity within interventions, targeted be...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-28
更新日期:2006-11-21 00:00:00
abstract:BACKGROUND:Hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygie...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-6-101
更新日期:2011-09-03 00:00:00
abstract:BACKGROUND:The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in dec...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0693-6
更新日期:2018-01-25 00:00:00
abstract:BACKGROUND:Patients with hypertension continue to have less than optimal blood pressure control, with nearly one in five Canadian adults having hypertension. Pharmacist prescribing is gaining favor as a potential clinically efficacious and cost-effective means to improve both access and quality of care. With Alberta be...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-6-94
更新日期:2011-08-11 00:00:00
abstract:BACKGROUND:There is a need to unpack the empirical, practical, and personal challenges within participatory approaches advocated to optimize implementation. The unpredictable, chaotic nature of participatory approaches complicates application of implementation theories, methods, and strategies which do not address rese...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01002-1
更新日期:2020-09-03 00:00:00
abstract:BACKGROUND:Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions i...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0392-8
更新日期:2016-03-23 00:00:00
abstract:BACKGROUND:With the current funding climate and need for advancements in implementation science, there is a growing demand for grantsmanship workshops to increase the quality and rigor of proposals. A group-based implementation science-focused grantsmanship workshop, the Implementation Development Workshop (IDW), is on...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0429-z
更新日期:2016-05-06 00:00:00
abstract:BACKGROUND:Care management in primary care can be effective in helping patients with chronic disease improve their health status. Primary care practices, however, are often challenged with its implementation. Incorporating care management involves more than a simple physical process redesign to existing clinical care r...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0316-z
更新日期:2015-08-21 00:00:00
abstract:BACKGROUND:Implementation researchers have typically studied organizational culture and climate by testing whether individual dimensions are linked to the implementation of evidence-based practices (EBPs) rather than examining how the overarching social context influences implementation. This approach may limit impleme...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
doi:10.1186/s13012-019-0863-9
更新日期:2019-02-12 00:00:00
abstract:BACKGROUND:Counselling on health-related lifestyles is key to the prevention and management of chronic diseases. After comprehensive study of determinants of its delivery in general practice and strategies to improve, we composed a tailored improvement program, which included communication skills training, online patie...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-016-0460-0
更新日期:2016-08-11 00:00:00
abstract:BACKGROUND:Osteoarthritis is a leading cause of pain and disability worldwide. Despite research supporting best practice, evidence-based guidelines are often not followed. Little is known about the implementation of non-surgical models of care in routine primary care practice. From a knowledge mobilisation perspective,...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01055-2
更新日期:2020-10-28 00:00:00
abstract::Economic evaluations can inform decisions about the efficiency and allocation of resources to implementation strategies-strategies explicitly designed to inform care providers and patients about the best available research evidence and to enhance its use in their practices. These strategies are increasingly popular in...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/s13012-014-0168-y
更新日期:2014-12-18 00:00:00
abstract:BACKGROUND:Health practice guidelines (HPGs) are important tools for the translation of evidence into practice. Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist provides guidance on reporting health practice guidelines (HPGs). We assessed the reporting completeness and quality of a set of nationa...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0828-4
更新日期:2018-10-29 00:00:00
abstract::Implementation research (IR) is growing in recognition as an important generator of practical knowledge that can be translated into health policy. With its aim to answer questions about how to improve access to interventions that have been shown to work but have not reached many of the people who could benefit from th...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0527-y
更新日期:2016-12-09 00:00:00
abstract:BACKGROUND:Services to treat tobacco dependence are not readily available to smokers in low-middle income countries (LMICs) where smoking prevalence remains high. We are conducting a cluster randomized controlled trial comparing the effectiveness of two strategies for implementing tobacco use treatment guidelines in 26...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0558-z
更新日期:2017-02-28 00:00:00
abstract:BACKGROUND:Substance misuse is now encountered in settings beyond addiction specialty care, with schools a point-of-contact for student access to behavioral health services. Marijuana is a leading impetus for adolescent treatment admissions despite declining risk perception, for which the Teen Marijuana Check-Up (TMCU)...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0633-5
更新日期:2017-08-10 00:00:00