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Trials
Published in: Trials 1/2014

Open Access 01-12-2014 | Study protocol

Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial

Authors: Rajesh Vedanthan, Jemima H Kamano, Violet Naanyu, Allison K Delong, Martin C Were, Eric A Finkelstein, Diana Menya, Constantine O Akwanalo, Gerald S Bloomfield, Cynthia A Binanay, Eric J Velazquez, Joseph W Hogan, Carol R Horowitz, Thomas S Inui, Sylvester Kimaiyo, Valentin Fuster

Published in: Trials | Issue 1/2014

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Abstract

Background

Hypertension is the leading global risk factor for mortality. Hypertension treatment and control rates are low worldwide, and delays in seeking care are associated with increased mortality. Thus, a critical component of hypertension management is to optimize linkage and retention to care.

Methods/Design

This study investigates whether community health workers, equipped with a tailored behavioral communication strategy and smartphone technology, can increase linkage and retention of hypertensive individuals to a hypertension care program and significantly reduce blood pressure among them. The study will be conducted in the Kosirai and Turbo Divisions of western Kenya. An initial phase of qualitative inquiry will assess facilitators and barriers of linkage and retention to care using a modified Health Belief Model as a conceptual framework. Subsequently, we will conduct a cluster randomized controlled trial with three arms: 1) usual care (community health workers with the standard level of hypertension care training); 2) community health workers with an additional tailored behavioral communication strategy; and 3) community health workers with a tailored behavioral communication strategy who are also equipped with smartphone technology. The co-primary outcome measures are: 1) linkage to hypertension care, and 2) one-year change in systolic blood pressure among hypertensive individuals. Cost-effectiveness analysis will be conducted in terms of costs per unit decrease in blood pressure and costs per disability-adjusted life year gained.

Discussion

This study will provide evidence regarding the effectiveness and cost-effectiveness of strategies to optimize linkage and retention to hypertension care that can be applicable to non-communicable disease management in low- and middle-income countries.

Trial registration

This trial is registered with (NCT01844596) on 30 April 2013.
Appendix
Available only for authorised users
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Metadata
Title
Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial
Authors
Rajesh Vedanthan
Jemima H Kamano
Violet Naanyu
Allison K Delong
Martin C Were
Eric A Finkelstein
Diana Menya
Constantine O Akwanalo
Gerald S Bloomfield
Cynthia A Binanay
Eric J Velazquez
Joseph W Hogan
Carol R Horowitz
Thomas S Inui
Sylvester Kimaiyo
Valentin Fuster
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Trials / Issue 1/2014
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-15-143

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