Community co-design of contextually relevant rheumatic heart disease primary prevention

Area of Science:

• Public Health
• Community Health
• Implementation Science

Background:

• Rheumatic heart disease (RHD) prevention relies on treating Group A Streptococcal infections like strep throat.
• Current RHD primary prevention efforts in endemic regions require enhanced uptake and delivery.
• Community co-design is crucial for developing sustainable and far-reaching health interventions.

Purpose of the Study:

• To understand community priorities for sore throat management.
• To develop user personas for RHD primary prevention.
• To identify and prioritize implementation strategies for RHD primary prevention through community co-design.

Main Methods:

• Group-level assessment (GLA) sessions to gather community insights on sore throat.
• Development of user personas representing diverse individuals.
• Community design workshops to identify barriers, generate solutions, and prioritize interventions.
• Community validation of proposed implementation strategies.

Main Results:

• Key community priorities included improved access to care, the role of mothers, community leaders, health workers, and traditional practices.
• Five personas were developed: caregiver, decision-maker, and leader archetypes.
• Top-rated interventions were decentralized care, utilizing community health workers, and streamlined facility-based services.

Conclusions:

• Community-based participatory research yielded novel strategies for RHD primary prevention in Uganda.
• The identified value sets and strategies can guide the development and testing of RHD prevention programs.
• This study provides a framework for improving RHD primary prevention through community engagement.