Qualitative Evaluation of a Complex Intervention to Improve Rheumatic Heart Disease Secondary Prophylaxis

Journal of the American Heart Association
Clancy ReadAnna P Ralph

Abstract

Rheumatic heart disease is a high-burden condition in Australian Aboriginal communities. We evaluated a stepped-wedge, community, randomized trial at 10 Aboriginal communities from 2013 to 2015. A multifaceted intervention was implemented using quality improvement and chronic care model approaches to improve delivery of penicillin prophylaxis for rheumatic heart disease. The trial did not improve penicillin adherence. This mixed-methods evaluation, designed a priori, aimed to determine the association between methodological approaches and outcomes. An evaluation framework was developed to measure the success of project implementation and of the underlying program theory. The program theory posited that penicillin delivery would be improved through activities implemented at clinics that addressed elements of the chronic care model. Qualitative data were derived from interviews with health-center staff, informants, and clients; participant observation; and project officer reports. Quantitative data comprised numbers and types of "action items," which were developed by participating clinic staff with project officers to improve delivery of penicillin injections. Interview data from 121 health-center staff, 22 informants, and 72 cl...Continue Reading

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Citations

Apr 18, 2019·Australian and New Zealand Journal of Public Health·Joshua R FrancisKate Hardie
May 16, 2019·Current Cardiology Reviews·John A Woods, Judith M Katzenellenbogen
Feb 26, 2020·International Journal of Environmental Research and Public Health·Emma HaynesDawn Bessarab
Nov 16, 2020·The Medical Journal of Australia·Rosemary WyberUNKNOWN END RHD CRE Investigators Collaborators
Mar 12, 2021·The Lancet Child & Adolescent Health·Rosemary WyberJonathan Carapetis
May 25, 2021·Australian and New Zealand Journal of Public Health·Rosemary WyberUNKNOWN END RHD Communities Investigator and Advisory Group
Aug 21, 2021·Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals·Leda SivakRosemary Wyber
Oct 3, 2021·Current Cardiology Reports·Joselyn RwebemberaBruno R Nascimento

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