Procedures
hypertension, CdeS
HYPERTENSION, CARDIOVASCULAR MORBIDITY
The interview guides were developed (by THJ, IJ, AdeS, AN, HLQ), pre-tested using probes and open-ended questions that were modelled on TFA to solicit the participants’ experienced acceptability of hypertension care in rural communities. A qualitative expert (HLQ) from Duke-NUS Singapore trained the site PIs at the icddr,b, Bangladesh, Aga Khan University, Pakistan, and University of Kelaniya, Sri Lanka, and all study coordinators in the common study protocol, qualitative methods, and principles of ethical research, and in using uniform probes modified to suit the local context. The guide covered opinions about experience, fit and acceptability of each component of the intervention, as relevant to the participants on: training of CHW and physicians, blood pressure monitoring and home health by CHWs, referrals to trained physicians using checklists and using treatment algorithm, hypertension triage counters and care coordinators at the government clinics, and compensation to CHW for additional services. This study allowed to understanding patients’ and healthcare providers’ attitudes on the acceptability and benefits of the intervention as well as their keenness on future participation which is important for long-term sustainability of the intervention and ultimately its effectiveness on reducing BP and cardiovascular morbidity and mortality.The in-depth interviews of healthcare providers were conducted at the primary healthcare centers (their duty stations), and patients’ interviews were conducted in the respondents’ home after a pre-scheduled appointment. A written informed consent was obtained for the interviews and audio-recordings. Interviews were conducted by trained bilingual data collectors or researchers in local languages (Bangla, Urdu, Sindhi, and Sinhalese), and audio-recorded, transcribed, and then translated in English. The transcripts in Bangla and Sinhalese were translated into English and rechecked by the site PI and study coordinator. The transcriptions were done directly in English in Pakistan. All transcripts were reviewed line by line and double-checked for accuracy by the site PI (AdeS, AN, IJ) and study coordinators (CdeS, NC, SS) jointly for any disagreement. The final transcripts from each country were used for analysis. The audio-recordings and interview notes were consulted for validation purpose and consensus, when necessary.