Protocol for a scoping review of implementation strategies for integrating evidence-based cardiometabolic disease care for adults into siloed health services in low- and middle-income countries

Background Cardiometabolic diseases, including type 2 diabetes, hypertension, obesity, and dyslipidemia, represent a growing burden in low- and middle-income countries (LMICs), where health systems have historically prioritized vertically organized infectious disease programs. While integrated care models co-locating cardiometabolic and infectious disease services have been increasingly documented, the implementation strategies used to design, deploy, and sustain these integrations have not been systematically characterized. Objective This scoping review aims to identify, characterize, and map the implementation strategies used to integrate evidence-based cardiometabolic disease care into established HIV, tuberculosis, and primary care platforms in LMIC settings. Methods We will conduct a structured search across five databases (PubMed, Embase, Cochrane Library, Web of Science, and CINAHL) following the methodological frameworks of Arksey and O'Malley and the Joanna Briggs Institute, and reporting in accordance with PRISMA-ScR guidelines. Eligible studies will undergo staged screening and data extraction by a team of trained reviewers, and the methodological quality of included studies will be appraised using the Mixed Methods Appraisal Tool (MMAT). Implementation strategies will be classified using the Expert Recommendations for Implementing Change (ERIC) framework; implementation context will be characterized to assess the setting, population, and circumstances of implementation; and implementation outcomes will be systematically assessed and characterized using the Proctor et al. taxonomy. Expected outputs Findings will be synthesized as a narrative and tabular evidence map characterizing the implementation strategies, implementation outcomes, evidence-based interventions, and contextual factors associated with cardiometabolic care integration in LMICs, with the aim of informing future implementation research, programmatic implementation, health systems reorganization, and policy development. Clinical Trial Registration This protocol was registered prospectively on the Open Science Framework ( https://doi.org/10.17605/OSF.IO/2E89M ).