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Dissemination and Implementation Program in Hypertension in Rwanda: Report on Initial Training and Evaluation.

Ana A Baumann1, Vincent Mutabazi2, Angela L Brown3

  • 1Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA.

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Summary

This study enhanced hypertension and cardiovascular disease control in Rwanda by improving research capacity and training. The project successfully increased knowledge and skills in dissemination and implementation strategies for healthcare professionals.

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Area of Science:

  • Public Health
  • Cardiovascular Research
  • Implementation Science

Background:

  • Hypertension (HTN) is a major global risk factor for cardiovascular disease (CVD), leading to significant morbidity and mortality, particularly in low- and middle-income countries.
  • Rwanda faces challenges in implementing evidence-based HTN control due to limited research capacity and infrastructure, with HTN prevalence at 15% in adults aged 15-64 and CVD being a leading cause of death.
  • Suboptimal infrastructure and capacity in Rwanda hinder research and community knowledge crucial for effective HTN control.

Purpose of the Study:

  • To assess regional infrastructure needs for dissemination and implementation (D & I) strategies targeting HTN-CVD control.
  • To build HTN-CVD research capacity in Rwanda through countrywide resources, including core facilities and training in D & I and biostatistics.
  • To engage and train diverse stakeholders in D & I principles and evidence-based interventions for HTN-CVD.

Main Methods:

  • A weeklong training program on HTN-CVD, biostatistics, and D & I was conducted in Rwanda in August 2018.
  • Pre- and post-training competency questionnaires were administered to assess knowledge and skill acquisition.
  • The study utilized community engagement and train-the-trainer methodologies.

Main Results:

  • Training significantly increased participants' knowledge and skills in dissemination and implementation (D & I).
  • Pre- to post-test scores demonstrated a statistically significant improvement (2.12 ± 0.78 vs. 3.94 ± 0.42, p < 0.0001).

Conclusions:

  • The project successfully enhanced dissemination and implementation (D & I) knowledge and skills among Rwandan healthcare professionals.
  • Adapting high-income country guidelines for HTN-CVD to Rwanda's context is crucial for sustainable disease burden management.
  • Establishing a sustainable platform through community engagement and capacity building is key to addressing HTN-CVD in Rwanda.