Task shifting of frontline community health workers for cardiovascular risk reduction: design and rationale of a cluster randomised controlled trial (DISHA study) in India

BMC Public Health

Study Protocol

Sulaiman Ladhani¹  Kashvi Kahol²  Dorothy Lall²  Dimple Kondal²  Nidhi Sobti²  Gitanjali Narayanan²  Deksha Kapoor²  Sathyaprakash Manimunda³  Dorairaj Prabhakaran⁴  Panniyammakal Jeemon⁴  Gurudyal Toteja⁵  Supriya Dwivedi⁵  Prakash Negi⁶  Anil Purty⁷  Ashok Bharadwaj⁸  Kuldeep Singh⁹  Jyoti Sanghvi⁹ 

[1] Aga Khan Health Services, Mumbai, India;Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana, India;Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana, India;National Centre for Disease Informatics and Research, ICMR, Bangalore, India;Centre for Control of Chronic Conditions, Public Health Foundation of India, New Delhi, India;Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana, India;Indian Council of Medical Research, New Delhi, India;Indira Gandhi Medical College, Shimla, India;Pondicherry Institute of Medical Sciences, Puducherry, India;Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India;Sri Aurbindo Institute of Medical Sciences, Indore, India;

关键词: Task shifting interventions;    Cardio-vascular disease;    Low and middle-income countries;    India;   

DOI  :  10.1186/s12889-016-2891-6

 received in 2016-01-13, accepted in 2016-02-18,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundEffective task-shifting interventions targeted at reducing the global cardiovascular disease (CVD) epidemic in low and middle-income countries (LMICs) are urgently needed.MethodsDISHA is a cluster randomised controlled trial conducted across 10 sites (5 in phase 1 and 5 in phase 2) in India in 120 clusters. At each site, 12 clusters were randomly selected from a district. A cluster is defined as a small village with 250–300 households and well defined geographical boundaries. They were then randomly allocated to intervention and control clusters in a 1:1 allocation sequence. If any of the intervention and control clusters were <10 km apart, one was dropped and replaced with another randomly selected cluster from the same district. The study included a representative baseline cross-sectional survey, development of a structured intervention model, delivery of intervention for a minimum period of 18 months by trained frontline health workers (mainly Anganwadi workers and ASHA workers) and a post intervention survey in a representative sample. The study staff had no information on intervention allocation until the completion of the baseline survey. In order to ensure comparability of data across sites, the DISHA study follows a common protocol and manual of operation with standardized measurement techniques.DiscussionOur study is the largest community based cluster randomised trial in low and middle-income country settings designed to test the effectiveness of ‘task shifting’ interventions involving frontline health workers for cardiovascular risk reduction.Trial registrationCTRI/2013/10/004049. Registered 7 October 2013.

【 授权许可】

CC BY   
© Jeemon et al. 2016