Study title: INTEgrating HypeRtension and Cardiovascular Diseases CARE into Existing HIV Services Package in Botswana

Primary aim: To measure the implementation outcomes of a multi-component strategy in improving evidence-based intervention uptake and improvement success rates in the hypertension care cascade among adults with a dual diagnosis of HIV and hypertension.

Study design: Type 2 hybrid effectiveness-implementation, cluster randomized trial

Setting/location: Urban and rural communities in southeastern Botswana (14 clinics)

Study participants: HIV-positive and hypertensive patients between 20-75 years of age who are on ART and registered as a client at a study clinic

Principal investigator: Mosepele Mosepele, University of Botswana

Co-Investigator and program manager: Nabila Youssouf, Botswana Harvard Partnership and London School of Hygiene and Tropical Medicine

MPIs: Tendani Gaolathe, University of Botswana; Shabbar Jaffar, Botswana Harvard Partnership

Summary:

The InterCARE intervention package has four main components: 1) training and coaching of healthcare providers (including doctors, nurses, pharmacists, laboratory technicians, and health educators) on how to prevent, monitor, and treat hypertension; 2) modification of electronic health record-keeping software to enhance data collection on hypertension/cardio-vascular disease care; 3) provision of basic equipment (such as blood pressure monitors) and guidance documents needed to clinics to support the monitoring and treatment of hypertension/cardio-vascular disease; and 4) education and counseling for patients with HIV and hypertension during their routine HIV clinic visits with support from treatment partners chosen by the study participant from their social network.

InterCARE will use the RE-AIM framework to assess the reach, effectiveness, and adoption of their intervention. Being the first project of its kind in Botswana, if successful, InterCARE protocols could be readily rolled out to health facilities nationwide to diagnose, treat, track, and support the estimated 25-30% Batswana with hypertension.