Living with Diversity Vol. I: 8-9 November 2008, University of Ljubljana

oai:ojs.hass.tsukuba.ac.jp:article/1Living with Diversity, volume I, documents the proceedings of the Slovenia-Japan University Cooperation Network Graduate Student Forum Series held at Ljubljana University in 2008. The proceedings comprise the individual research papers as well as detailed reports of the three discussion sessions. While the individual papers discuss issues from each researcher’s specific field of expertise within the federating theme, the three discussion sessions address a wide range of issues and problems concerning identity, society and language from an essentially trans-disciplinary perspective. 『多様性を生きる』第1巻は、2008年にリュブリャナ大学において開催された「スロベニア・日本学生知的交流会議」の報告書です。本報告書は、個々の論文および3つのディスカッション・セッションの詳報を収めています。各論文においては、統一テーマの枠内で、研究者が各自の専門領域から問題を論じているのに対して、3つのディスカッション・セッションにおいては、本質的に領域横断的な視点から、アイデンティティ、社会、言語に関する広範な論点と課題を取り上げています

Systems analysis and improvement approach to optimize the hypertension diagnosis and care cascade for PLHIV individuals (SAIA-HTN): a hybrid type III cluster randomized trial. : A hybrid type III cluster randomized trial

Funding Information: The Research reported in this publication is supported by NHLBI, NICHD, NIAID, NCI, NIMH, NIDA, NIA of the National Institutes of Health under award numbers R01HL142412 and P30AI027757. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: © 2020 The Author(s).Background: Across sub-Saharan Africa, evidence-based clinical guidelines to screen and manage hypertension exist; however, country level application is low due to lack of service readiness, uneven health worker motivation, weak accountability of health worker performance, and poor integration of hypertension screening and management with chronic care services. The systems analysis and improvement approach (SAIA) is an evidence-based implementation strategy that combines systems engineering tools into a five-step, facility-level package to improve understanding of gaps (cascade analysis), guide identification and prioritization of low-cost workflow modifications (process mapping), and iteratively test and redesign these modifications (continuous quality improvement). As hypertension screening and management are integrated into chronic care services in sub-Saharan Africa, an opportunity exists to test whether SAIA interventions shown to be effective in improving efficiency and coverage of HIV services can be effective when applied to the non-communicable disease services that leverage the same platform. We hypothesize that SAIA-hypertension (SAIA-HTN) will be effective as an adaptable, scalable model for broad implementation. Methods: We will deploy a hybrid type III cluster randomized trial to evaluate the impact of SAIA-HTN on hypertension management in eight intervention and eight control facilities in central Mozambique. Effectiveness outcomes include hypertension cascade flow measures (screening, diagnosis, management, control), as well as hypertension and HIV clinical outcomes among people living with HIV. Cost-effectiveness will be estimated as the incremental costs per additional patient passing through the hypertension cascade steps and the cost per additional disability-adjusted life year averted, from the payer perspective (Ministry of Health). SAIA-HTN implementation fidelity will be measured, and the Consolidated Framework for Implementation Research will guide qualitative evaluation of the implementation process in high-and low-performing facilities to identify determinants of intervention success and failure, and define core and adaptable components of the SAIA-HTN intervention. The Organizational Readiness for Implementing Change scale will measure facility-level readiness for adopting SAIA-HTN. Discussion: SAIA packages user-friendly systems engineering tools to guide decision-making by front-line health workers to identify low-cost, contextually appropriate chronic care improvement strategies. By integrating SAIA into routine hypertension screening and management structures, this pragmatic trial is designed to test a model for national scale-up. Trial registration: ClinicalTrials.gov NCT04088656 (registered 09/13/2019; https://clinicaltrials.gov/ct2/show/NCT04088656).Peer reviewe

Erratum : Systems analysis and improvement approach to optimize the hypertension diagnosis and care cascade for PLHIV individuals (SAIA-HTN): A hybrid type III cluster randomized trial (Implementation Sci. (2020) 15:15 DOI: 10.1186/s13012-020-0973-4)

Publisher Copyright: © 2020 The Author(s). Reference:.Following publication of the original article [1], the authors reported a typo in the title of the article. In this Correction the incorrect and correct title are shown, with the correction shown in bold. The original article has been corrected. Originally the title was published as: Systems analysis and improvement approach to optimize the hypertension diagnosis and case cascade for PLHIV individuals (SAIA-HTN): a hybrid type III cluster randomized trial The correct title is: Systems analysis and improvement approach to optimize the hypertension diagnosis and care cascade for PLHIV individuals (SAIA-HTN): a hybrid type III cluster randomized trial