Key result
COACH pilot trial evaluates integrating community health worker-delivered hypertension care into Tanzanian HIV clinics.
Why the study?
To evaluate the feasibility and preliminary effectiveness of the COACH intervention, which integrates hypertension management into existing HIV care for people living with HIV in Tanzania.
Does the COACH intervention improve the feasibility of hypertension care and blood pressure control in people living with HIV and hypertension?
Does the COACH intervention improve the feasibility of hypertension care and blood pressure control in people living with HIV and hypertension?
This study protocol outlines a pilot trial to evaluate the feasibility and preliminary effectiveness of integrating hypertension management into HIV care using community health workers in Tanzania.
CHW-integrated hypertension care in Tanzanian HIV clinics remains untested; pilot data will inform whether larger trials are warranted.
OBJECTIVE: This study will evaluate the feasibility and preliminary effectiveness of the COACH (Community Health Worker Optimization of Antihypertensive Care in HIV) intervention, which integrates hypertension management into existing HIV care for people living with HIV (PLWH) in Tanzania. METHODS: The study will be conducted at two HIV Care and Treatment Centers (CTCs) in Tanzania. In a single-arm pre-post feasibility trial, 100 PLWH with hypertension will be enrolled and will receive the six-month intervention. The COACH intervention includes six monthly hypertension educational sessions delivered by community health workers (CHWs) and integrated within HIV CTC visits, monthly blood pressure monitoring, follow up care coordination, fully subsidized antihypertensive medications, a standardized antihypertensive treatment algorithm, and training for providers. The intervention's implementation outcomes will be evaluated using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework, and the primary study outcome (reach of the intervention) will be the proportion of all scheduled intervention sessions attended by participants, a measure of feasibility. Secondary clinical effectiveness outcomes will include adherence to antihypertensive medication, blood pressure control, body mass index, cardiovascular risk, and hypertension knowledge. SIGNIFICANCE: The COACH intervention has the potential to significantly improve hypertension management among PLWH in Tanzania by leveraging the existing HIV care infrastructure and CHWs. This study will provide crucial insights into the feasibility and potential effectiveness of the intervention in integrating hypertension care into HIV services, informing larger-scale implementation and policy changes in Tanzania and other resource-limitted settings. TRIAL REGISTRATION: Clinical trials.gov Identifer: NCT06503991.
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Htike et al. (2024) studied HIV and hypertension (n=100). COACH intervention was evaluated on Proportion of all scheduled intervention sessions attended by participants (reach/feasibility). The COACH intervention pilot trial will evaluate the feasibility and preliminary effectiveness of integrating community health worker-delivered hypertension care into existing HIV clinics in Tanzania.
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