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Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria

BACKGROUND: Given the growing burden of cardiovascular diseases in sub-Saharan Africa, global donors and governments are exploring strategies for integrating evidence-based cardiovascular diseases prevention into HIV clinics. We assessed the capabilities, motivations and opportunities that exist for...

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Autores principales: Iwelunmor, Juliet, Ezechi, Oliver, Obiezu-Umeh, Chisom, Gbajabiamila, Titilola, Musa, Adesola Z., Oladele, David, Idigbe, Ifeoma, Ohihoin, Aigbe, Gyamfi, Joyce, Aifah, Angela, Salako, Babatunde, Ogedegbe, Olugbenga
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553742/
https://www.ncbi.nlm.nih.gov/pubmed/31170220
http://dx.doi.org/10.1371/journal.pone.0217703
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author Iwelunmor, Juliet
Ezechi, Oliver
Obiezu-Umeh, Chisom
Gbajabiamila, Titilola
Musa, Adesola Z.
Oladele, David
Idigbe, Ifeoma
Ohihoin, Aigbe
Gyamfi, Joyce
Aifah, Angela
Salako, Babatunde
Ogedegbe, Olugbenga
author_facet Iwelunmor, Juliet
Ezechi, Oliver
Obiezu-Umeh, Chisom
Gbajabiamila, Titilola
Musa, Adesola Z.
Oladele, David
Idigbe, Ifeoma
Ohihoin, Aigbe
Gyamfi, Joyce
Aifah, Angela
Salako, Babatunde
Ogedegbe, Olugbenga
author_sort Iwelunmor, Juliet
collection PubMed
description BACKGROUND: Given the growing burden of cardiovascular diseases in sub-Saharan Africa, global donors and governments are exploring strategies for integrating evidence-based cardiovascular diseases prevention into HIV clinics. We assessed the capabilities, motivations and opportunities that exist for HIV clinics to apply evidence-based strategies for hypertension control among people living with HIV (PLHIV) in Nigeria. METHODS: We used a concurrent Quan-Qual- study approach (a quantitative first step using structured questionnaires followed by a qualitative approach using stakeholder meetings).We invited key stakeholders and representatives of HIV and non-communicable disease organizations in Lagos, Nigeria to 1) assess the capacity of HIV clinics (n = 29) to, and; 2) explore their attitudes and perceptions towards implementing evidence-based strategies for hypertension management in Lagos, Nigeria (n = 19)The quantitative data were analyzed using SPSS whereas responses from the stakeholders meeting were coded and analyzed using thematic approach and an implementation science framework, the COM-B (Capabilities, Opportunities, Motivations and Behavior) model, guided the mapping and interpretation of the data. RESULTS: Out of the 29 HIV clinics that participated in the study, 28 clinics were public, government-owned facilities with 394 HIV patients per month with varying capabilities, opportunities and motivations for integrating evidence-based hypertension interventions within their services for PLHIV. Majority of the clinics (n = 26) rated medium-to-low on the psychological capability domains, while most of the clinics (n = 25) rated low on the physical capabilities of integrating evidence-based hypertension interventions within HIV clinics. There was high variability in the ratings for the opportunity domains, with physical opportunities rated high in only eight HIV clinics, two clinics with a medium rating and nineteen clinics with a low rating. Social opportunity domain tended to be rated low in majority of the HIV clinics (n = 21). Lastly, almost all the HIV clinics (n = 23) rated high on the reflective motivation domain although automatic motivations tended to be rated low across the HIV clinics. CONCLUSION: In this study, we found that with the exception of motivations, the relative capabilities whether physical or psychological and the relative opportunities for integrating evidence-based hypertension intervention within HIV clinics in Nigeria were minimal. Thus, there is need to strengthen the HIV clinics in Lagos for the implementation of evidence-based hypertension interventions within HIV clinics to improve patient outcomes and service delivery in Southwest Nigeria.
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spelling pubmed-65537422019-06-17 Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria Iwelunmor, Juliet Ezechi, Oliver Obiezu-Umeh, Chisom Gbajabiamila, Titilola Musa, Adesola Z. Oladele, David Idigbe, Ifeoma Ohihoin, Aigbe Gyamfi, Joyce Aifah, Angela Salako, Babatunde Ogedegbe, Olugbenga PLoS One Research Article BACKGROUND: Given the growing burden of cardiovascular diseases in sub-Saharan Africa, global donors and governments are exploring strategies for integrating evidence-based cardiovascular diseases prevention into HIV clinics. We assessed the capabilities, motivations and opportunities that exist for HIV clinics to apply evidence-based strategies for hypertension control among people living with HIV (PLHIV) in Nigeria. METHODS: We used a concurrent Quan-Qual- study approach (a quantitative first step using structured questionnaires followed by a qualitative approach using stakeholder meetings).We invited key stakeholders and representatives of HIV and non-communicable disease organizations in Lagos, Nigeria to 1) assess the capacity of HIV clinics (n = 29) to, and; 2) explore their attitudes and perceptions towards implementing evidence-based strategies for hypertension management in Lagos, Nigeria (n = 19)The quantitative data were analyzed using SPSS whereas responses from the stakeholders meeting were coded and analyzed using thematic approach and an implementation science framework, the COM-B (Capabilities, Opportunities, Motivations and Behavior) model, guided the mapping and interpretation of the data. RESULTS: Out of the 29 HIV clinics that participated in the study, 28 clinics were public, government-owned facilities with 394 HIV patients per month with varying capabilities, opportunities and motivations for integrating evidence-based hypertension interventions within their services for PLHIV. Majority of the clinics (n = 26) rated medium-to-low on the psychological capability domains, while most of the clinics (n = 25) rated low on the physical capabilities of integrating evidence-based hypertension interventions within HIV clinics. There was high variability in the ratings for the opportunity domains, with physical opportunities rated high in only eight HIV clinics, two clinics with a medium rating and nineteen clinics with a low rating. Social opportunity domain tended to be rated low in majority of the HIV clinics (n = 21). Lastly, almost all the HIV clinics (n = 23) rated high on the reflective motivation domain although automatic motivations tended to be rated low across the HIV clinics. CONCLUSION: In this study, we found that with the exception of motivations, the relative capabilities whether physical or psychological and the relative opportunities for integrating evidence-based hypertension intervention within HIV clinics in Nigeria were minimal. Thus, there is need to strengthen the HIV clinics in Lagos for the implementation of evidence-based hypertension interventions within HIV clinics to improve patient outcomes and service delivery in Southwest Nigeria. Public Library of Science 2019-06-06 /pmc/articles/PMC6553742/ /pubmed/31170220 http://dx.doi.org/10.1371/journal.pone.0217703 Text en © 2019 Iwelunmor et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Iwelunmor, Juliet
Ezechi, Oliver
Obiezu-Umeh, Chisom
Gbajabiamila, Titilola
Musa, Adesola Z.
Oladele, David
Idigbe, Ifeoma
Ohihoin, Aigbe
Gyamfi, Joyce
Aifah, Angela
Salako, Babatunde
Ogedegbe, Olugbenga
Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria
title Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria
title_full Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria
title_fullStr Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria
title_full_unstemmed Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria
title_short Capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into HIV clinics in Southwest Nigeria
title_sort capabilities, opportunities and motivations for integrating evidence-based strategy for hypertension control into hiv clinics in southwest nigeria
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553742/
https://www.ncbi.nlm.nih.gov/pubmed/31170220
http://dx.doi.org/10.1371/journal.pone.0217703
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