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Scaling Out and Scaling Up the Systems Analysis and Improvement Approach to Optimize the Hypertension Diagnosis andCare Cascade for HIV-infected Individuals (SCALE SAIA HTN)

Award Number: UH3HL156390
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/10/2020
PERIOD OF PERFORMANCE END DATE: 08/31/2025

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Scaling Out and Scaling Up the Systems Analysis and Improvement Approach to Optimize the Hypertension Diagnosis andCare Cascade for HIV-infected Individuals (SCALE SAIA HTN) - Undiagnosed and untreated hypertension (HTN) is a main driver of cardiovascular disease, contributing to a third of deaths globally, disproportionately affecting low and middle-income countries. Across sSA, country- level application of evidence-based guidelines to screen and manage HTN is low and variable due to lack of service readiness, uneven health worker motivation, weak health worker accountability systems, and poor integration of HTN screening and management with chronic care services. In Mozambique, where HIV prevalence is >13%, the HIV treatment platform is the only scaled chronic care service. With over 900,000 patients on anti-retroviral therapy, it presents an opportunity to standardize and scale HTN care cascade services. Low-cost, systems-level strategies are effective in improving linked cascade services and may be effective for routinizing HTN diagnosis and management within existing HIV services; improving flow through the HTN cascade; and improving patient-level outcomes. Our proposal builds on the ongoing SAIA-HTN trial. The overall objective of our UG3/UH3 (SCALE SAIA- HTN) is to establish a robust evidence base on the effectiveness of a multi-component implementation strategy (SAIA) on the HTN/HIV cascade using a ‘scaling-out’ framework, whereby strength can be ‘borrowed’ from prior effectiveness trials. SCALE SAIA-HTN will be ‘scaled out’ through a novel modality delivered by district health supervisors (rather than study nurses). We will also ‘scale up’ SAIA-HTN by expanding to all districts in two additional provinces (15 districts), serving as a foundation for national scale-up. We propose three aims for the UG3 (Planning) and two for UH3 (Implementation) phases. UG3-Aim 1: To develop a multi-sectoral partnership of key stakeholders and establish HTN technical working groups at the national level and with participating provinces. UG3-Aim 2: To identify key facilitators and barriers that could affect the adoption, integration, scale-up and sustainment of the SAIA-HTN implementation strategy. UG3-Aim 3: To conduct a pilot study to assess feasibility and acceptability of the district supervisor-led SAIA-HTN intervention over six months in one primary care facility and redesign tools and standard operating procedures as necessary for the UH3 phase. UH3-Aim 1: Develop a district-based dissemination and implementation strategy for SCALE SAIA- HTN using the RE-AIM model to evaluate the programs’ Reach, Effectiveness, Adoption, Implementation and Maintenance. UH3-Aim 2: Determine the costs of SCALE SAIA-HTN for care cascade optimization. We will estimate total incremental and unit costs of integrating HTN diagnosis and management into HIV care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $1,108,180 )
2024	2024	UNIVERSIDADE EDUARDO MONDLANE	AVENIDA JULIUS NYERERE NR. 3453	MAPUTO				MOZ	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	5	9/13/2024	NON-COMPETING CONTINUATION	$712,623
2024	2022	UNIVERSIDADE EDUARDO MONDLANE	AVENIDA JULIUS NYERERE NR. 3453	MAPUTO				MOZ	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	3	12/20/2023	EXTENSION WITH OR WITHOUT FUNDS	$395,557
														Subtotal = $1,108,180

Issue Date FY: 2023 ( Subtotal = $794,037 )
2023	2023	UNIVERSIDADE EDUARDO MONDLANE	AVENIDA JULIUS NYERERE NR. 3453	MAPUTO				MOZ	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	002	4	9/4/2023	NON-COMPETING CONTINUATION	$794,037
2023	2022	UNIVERSIDADE EDUARDO MONDLANE	CAMPUS UNIV.	MAPUTO				MOZ	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	3	1/12/2023	EXTENSION WITH OR WITHOUT FUNDS	$0
2023	2022	UNIVERSIDADE EDUARDO MONDLANE	CAMPUS UNIV.	MAPUTO				MOZ	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	3	1/5/2023	EXTENSION WITH OR WITHOUT FUNDS	$0
														Subtotal = $794,037

Issue Date FY: 2022 ( Subtotal = $778,610 )
2022	2022	UNIVERSIDADE EDUARDO MONDLANE	CAMPUS UNIV.	MAPUTO				MOZ	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	3	9/15/2022	EXTENSION WITH OR WITHOUT FUNDS	$778,610
														Subtotal = $778,610

Grand Total All Awards = $2,680,827

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Scaling Out and Scaling Up the Systems Analysis and Improvement Approach to Optimize the Hypertension Diagnosis andCare Cascade for HIV-infected Individuals (SCALE SAIA HTN)

Award Number: UH3HL156390

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/10/2020

PERIOD OF PERFORMANCE END DATE: 08/31/2025

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