The Effectiveness of Text Messaging for Detection and Management of Hypertension in Indigenous People in Canada: Protocol for a Randomized Controlled Trial

Yeates, Karen; Campbell, Norm R.C.; Maar, Marion; Perkins, Nancy; Liu, Peter; Sleeth, Jessica; Smith, C. I. E.; McAllister, Colin; Hua‐Stewart, Diane; Wells, George A.; Tobe, Sheldon W.

doi:10.2196/resprot.7139

Cited by 17 publications

(29 citation statements)

References 36 publications

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“…Among the 15 studies funded by the GACD, 8 incorporated task-shifting from physicians to other cadres of the health workforce to manage hypertension. These studies were conducted in Argentina,14 Canada,15 Colombia, Ghana,16 India,17 18 Kenya,19 Malaysia, South Africa20 and Tanzania 15. All studies were randomised controlled trials, with one being a randomised controlled feasibility study.…”

Section: Introductionmentioning

confidence: 99%

“…Some interventions included delivery of medications14 and ongoing monitoring of BP 14 18. In Tanzania, a programme of cost-sharing through a mobile money platform and a health insurance scheme for low-income earners was introduced with the aim of increasing patient compliance with refilling antihypertensive medications and reducing cost to patients (as drug access through the government-funded health centre was unreliable) 15. In the HOPE-4 study, CHWs in Columbia and Malaysia were able to initiate appropriate CVD medications as well as follow up patients at regular intervals.…”

Section: Introductionmentioning

confidence: 99%

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Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases

et al. 2018

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Task-shifting to non-physician health workers (NPHWs) has been an effective model for managing infectious diseases and improving maternal and child health. There is inadequate evidence to show the effectiveness of NPHWs to manage cardiovascular diseases (CVDs). In 2012, the Global Alliance for Chronic Diseases funded eight studies which focused on task-shifting to NPHWs for the management of hypertension. We report the lessons learnt from the field. From each of the studies, we obtained information on the types of tasks shifted, the professional level from which the task was shifted, the training provided and the challenges faced. Additionally, we collected more granular data on ‘lessons learnt ’ throughout the implementation process and ‘design to implementation’ changes that emerged in each project. The tasks shifted to NPHWs included screening of individuals, referral to physicians for diagnosis and management, patient education for lifestyle improvement, follow-up and reminders for medication adherence and appointments. In four studies, tasks were shifted from physicians to NPHWs and in four studies tasks were shared between two different levels of NPHWs. Training programmes ranged between 3 and 7 days with regular refresher training. Two studies used clinical decision support tools and mobile health components. Challenges faced included system level barriers such as inability to prescribe medicines, varying skill sets of NPHWs, high workload and staff turnover. With the acute shortage of the health workforce in low-income and middle-income countries (LMICs), achieving better health outcomes for the prevention and control of CVD is a major challenge. Task-shifting or sharing provides a practical model for the management of CVD in LMICs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases

et al. 2018

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“…The scope and extent of use of this tool with respect to important population health issues has expanded rapidly, with various trials being designed or launched on repeat suicidal episodes prevention (28), type II diabetes prevention (29), detection and management of hypertension in indigenous people (30), diabetes self-management in low or middle-income countries (31), secondary prevention of coronary heart disease and diabetes (32), and increasing acceptability and use of effective contraception among young women (33). The impact of such a tool in reducing maternal and infant mortality and severe morbidity in low and middle-income countries such as China has not been well documented.…”

Section: Discussionmentioning

confidence: 99%

The Impact of a Maternal Education Program Through Text Messaging in Rural China: Cluster Randomized Controlled Trial (Preprint)

Xie¹,

Tan²,

Taljaard³

et al. 2018

Preprint

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“…DREAM‐GLOBAL was a multicenter double blind parallel group study conducted in First Nations populations living on reserve in six different communities in three provinces of Canada. The full protocol has been previously published . The details of how participating First Nations communities were identified and assessed for research readiness have been previously described .…”

Section: Methodsmentioning

confidence: 99%

“…The full protocol has been previously published . The details of how participating First Nations communities were identified and assessed for research readiness have been previously described . Participants were randomized into one of two parallel groups to receive either active and passive, or only passive SMS.…”

Section: Methodsmentioning

confidence: 99%

Diagnosing hypertension in Indigenous Canadians (DREAM‐GLOBAL): A randomized controlled trial to compare the effectiveness of short message service messaging for management of hypertension: Main results

Tobe

Yeates

Campbell

et al. 2018

J of Clinical Hypertension

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Hypertension, the leading cause of cardiovascular morbidity and mortality, affects more than 1 billion people globally. The rise in mobile health in particular the use of mobile phones and short message service (SMS) to support disease management provides an opportunity to improve hypertension awareness, treatment, and control, in remote and vulnerable patient populations. The primary objective of this randomized controlled study was to assess the effect of active (with hypertension specific management SMS) or passive (health behaviors SMS alone) on the difference in blood pressure (BP) reduction between the active and passive SMS groups in hypertensive Canadian First Nations people from six rural and remote communities. Pragmatic features of the study included shifting of BP measures to non‐medical health workers. Despite an overall reduction in BP over the study, there was no difference in the BP change between groups from baseline to final for systolic 0.8 (95% CI −4.2 to 5.8 mm Hg) or diastolic −1.0 (95% CI −3.7 to 1.8 mm Hg, P = 0.5) BP. Achieved BP control was 37.5% (25.6%‐49.4%, 95% CI) in the active group and 32.8% (20.6%‐44.8%, 95% CI) in the passive group (difference in proportions −4.74% (−21.7% to 12.2%, 95% CI, P = 0.6). The study looked at changes in health services delivery, mobile health technologies, and patient engagement to support better management of hypertension in Canadian First Nations communities. The active hypertension specific SMS did not lead to improvements in BP control.

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The Effectiveness of Text Messaging for Detection and Management of Hypertension in Indigenous People in Canada: Protocol for a Randomized Controlled Trial

Abstract: This document is for information only. Official payment is stated on the CIHR Authorization for Funding. Document à titre d'information seulement. Le paiement officiel est indiqué sur l'autorisation de financement des IRSC.

Cited by 17 publications

References 36 publications

Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases

Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases

The Impact of a Maternal Education Program Through Text Messaging in Rural China: Cluster Randomized Controlled Trial (Preprint)

Diagnosing hypertension in Indigenous Canadians (DREAM‐GLOBAL): A randomized controlled trial to compare the effectiveness of short message service messaging for management of hypertension: Main results

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